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Subject:
From:
"Linda L. Pohl, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 15 Dec 2003 15:06:06 -0700
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Mary -

You must be very frustrated.  It is so hard when you give moms information
and they do not seem to listen, especially when you know it would help the
breastfeeding.

I know you have had a lot of good suggestions from the list, especially
about asking the mom what she is actually willing to do.  Once you know what
she will do, it is easier to not bang your head against the wall with what
she isn't doing.

The one tidbit that I will offer is in regards to the shield and the SNS.
If you choose to use them together and you pull the tube through the hole in
the shield, you run the risk of having the baby sucking on the tube alone.
If, instead, you keep the tubing in the shield, extending only the to tip of
the shield it seems to work more effectively.  In effect, the tubing is
under the shield and the baby does not feel it.  If the tubing slips you can
anchor it.  It is easier to show you but I will try to make a word picture.

Make two small snips parallel to the outside edge of the shield.  Both snips
are less than 1/4 inch (5 mm) long and are very near the edge of the flat
part of the shield (as far as they can be from baby's mouth.)  The snips are
about 1/2-inch (1 cm) apart and parallel to each other ant the edge of the
shield.  Next thread the tubing through the snips.  First go up from the
bottom side of the shield and then down from the top of the shield.  (This
works kind of like the lacing cards that you may have played with as a kid.)
Next stretch the tubing so that it ends very near the tip of the shield.
Now apply the shield to the mom.

To apply the shield, I have found it most effective to turn the shield
almost inside out so that the part that fits over the nipple is about
one-eighth inch (3 mm) longer than mom's nipple.  When you do this, the
tubing will flip out of the tip.  Do not worry about it and do not stretch
it any further.  Now to apply the shield to mom's breast, tuck the loose end
of the tubing into the tip of the shield (without stretching the tubing any
longer) and place over mom's nipple.  Using four fingers, the first two from
each hand, put pressure down the side of the tip of the shield until it
"pops" out, grabbing the nipple tip.

This technique works better with the larger sized shield rather than the
newborn but either can be used.

Good luck with this mom.

Linda Pohl, IBCLC
www.eBESTFed.com

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