In addition to the excellent suggestions already given, this is one
situation where I have resorted to a shield in a couple cases.
Certainly, using a shield can introduce additional problems and good
instructions and follow-up are essential.  However, I did find that
the barrier between baby's mouth and the sensitive nipples made it
tolerable for mom.  I would much rather see a mom nursing with a
shield than formula feeding any day!

Along the same lines, one mom I saw in hospital recently planned to
only pump and bottle feed.  She was firm on that decision and did
not want to hear about any other approaches.  It was obvious the
goal would be 1-to feed baby and 2-establish the milk supply, but we
wouldn't get to the 3rd step (getting the first 2 together).  It was
a very busy day and I did not take the time I should have to explore
her reasons before jumoing in and giving instructions/suggestions.
I always suggest to moms who are pumping that they briefly roll the
nipples between their fingers or brush them with their fingertips to
stimulate teh nerve endings ("baby's mouth does that while he's
nursing, but a plastic flange just isn't the same").  Fortunately,
the mom spoke up and said that was out of the question because it
was nipple sensitivity that led her to pumping.  I immediately told
her it wasn't essential that she do that.  Looking for an acceptable
alternative, I did suggest she might place a warm washcloth over her
nipples briefly before pumping instead and she felt she could
tolerate that.  My thought was that the warmth would be relaxing and
the contact of the washcloth to the nipples would be better than no
stimulation.
Does this sound like a reasonable suggestion?  Has anyone else tried
it?  I just came up with it without giving it a lot of thought, but
felt I needed to offer an alternative that fit this mom's situation.

Winnie

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