Dear Nikki,
I hope I can get this right, word it in a way that will make sense to
more people than just me!!
First of all, let me state; I am a believer in the intelligence of
the newborn, and they sometimes get here angry. I love s2s, cranial
work, and watching, listening to baby's cues.
Sometimes, I think they aren't quite ready to be here and are a
little confused by all of their new surroundings. With these babies,
I swaddle them and have the parents hold them tight. I would love to
swaddle these babies in something dark red or purple, the colors of
the womb, but it isn't always possible. I also use a nipple shield,
if needed, for 2 reasons; 1. It is very distinctive and obvious which
may be all the encouragement the baby needs to start recognizing food
sources. 2. If latch is a problem, it is an easy tool to use to teach
the baby to open wide and hold on tight!
I have heard many times about supply issue and nipple shields (save
the letters!), supply is not an issue in the first few days PP as
lactogenisis 1 takes place as a response to the delivery of the
placenta, NOT stimulation so the nipple shield in the first 3 days is
a great non-invasive, non-traumatic way to get the baby to the
breast. A confused/angry baby will grab onto a shield rather quickly
and suck and calm down. Please, what is more important? A crying baby
or a happy baby? If, after a few days, we need to get rid of the
shield, it is easier with a baby who now feels secure and safe.
Sometimes I will teach finger calming with a big finger placed well
into the baby's mouth. Why? Because the babies 'get it'. They
realize, 'oh, something is in my mouth, suck, oh suck, oh, I get it,
SUCK. Oh, that feels good, that feels comforting. Finally these big
people are figuring out what I need.' These tools can often times get
these new families over the traumatic part quickly and easily and
give everybody some time to heal emotionally and physically. Which,
in turn gives them more strength to face the next hurdles with more
confidence and less fear.
I have been using nipple shields for years and truly believe, when
used properly, they are one of the greatest tools ever invented
(sorry Jack, it's true). Have I ever seen them compromise a milk
supply? Yes, twice. But, pumping wasn't helping either, nor was the
crummy latch the baby had without the shield. That is why I am
vigilant when they are used. Have I ever seen them save a
breastfeeding career? YESSSS many, many times WITHOUT compromising
the milk supply and the babies transition off of them with ease.
Nothing will stop me from having them as a part of my 'bag of
tricks'. I would be lost without them and my clients would suffer
harder and longer unnecessarily. "First do no Harm". Some of these
babies have been so traumatized during their long and arduous
'assisted' births, they can't latch properly, they won't latch
properly and the latch cannot be fixed in a day. I need a quick and
easy 'stop-gap' measure until some sort of normalcy returns.
Sometimes, they cry a bit when first swaddled but they tend to calm
and latch when they wouldn't latch with s2s. The last client I had
with this kind of baby had a NATURAL birth. It took SIX weeks to get
everybody on track. I pretty well had to break out every trick I know
and spent hours and hours with them either in person or on the phone.
The parents would tell me "she hates being swaddled" but she hated
flailing and screaming more. At 6 weeks she is (they all are) AMAZING
in their lives. Mommy has a full supply of milk, no shields, latches
like a champ and NOONE is crying any more!! It is a sight for sore eyes.
Please don't underestimate the value of swaddling a disorganized/
angry/confused newborn. When they are calm or sleeping, it is a great
time for s2s. Sometimes, tincture of time is the best healer and
doing whatever humanly possible to get these babies to feel safe,
secure and not crying. IMHO a crying, flailing baby is a big red
flag. A red flag not to be ignored. Maybe wrapping the baby to the
mom or dad would help these babies to feel secure and accomplish s2s
at the same time. I think too much room to move is very scary for
these little ones. I watch their little hands, feet and brows for
signs of relaxation and security. When I get these positive signs, I
know I am on the right track and I encourage the parents to continue
in that mode, whatever it may be, until it becomes VERY obvious the
baby has recovered from whatever set her/him off in the first place.
We need to ease this transition from 'free womb and board' to 'will
work for food' for these little guys. That is my goal. These tools
are what work for me.
Cheers,
Annie VerSteeg IBCLC
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