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Subject:
From:
Laura Spitzfaden <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 30 Aug 2012 23:29:37 -0400
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I have helped moms breastfeed their babies with nipple shields and I have helped them with SNS and other home-made lactation aids but today was the first time I helped a mom use a nipple shield with a SNS and it worked fabulously.

PTP.

This baby was 7 days old and not latching to the breast except with a nipple shield.  Mom was pumping and syringe feeding and latching with the shield when baby was willing.  We did before and after weighs and baby was not transferring with the shield.  Also, when baby was syringe feeding, she showed stress signs and gulped and had a lot of stridor.  Her suckling was very disorganized.  This baby is very obviously tongue and lip-tied and mom is going to pursue frenotomy.  Fortunately we have an excellent provider within driving distance.

Mom has been working very hard at pumping and feeding and baby is gaining appropriately.  When we finally tried the SNS and nipple shield together, this 7 day old baby suddenly changed to very organized suckling and transferred 20 ml in 10 minutes and was very content. Baby can now feed comfortably and the difference is striking.  I do have a few questions.

Since I haven't before witnessed this particular feeding intervention, I was not sure that a sound I was hearing was appropriate.  The baby has a very good suckling rhythm, with 1-2 sucks per swallow and she was making regular soft swallowing sounds.  I also hear a burbling noise that I haven't heard with the nipple shield or SNS alone.  It sounded like the noise that the starter SNS makes when you squeeze the bulb to prime it, but it was constant.  Baby did not appear to be swallowing air.  Her suck, swallow, breathe looked relaxed and appropriate and her whole body was relaxed while she fed.  Does anyone know what this sound means?

Baby was not willing (or maybe not able) to latch deeply to the nipple shield, so she still didn't get any milk directly from the breast (test weighs showed only transfer from SNS) so this may have affected how the suckling sounded.

My hope is that when baby becomes accustomed to milk transferring at the breast, she will be more willing to tolerate working on latch.

Any thoughts?

Laura Spitzfaden, LLLL, IBCLC

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