>Hello.  I am hoping that someone can help me.  A mom had her baby on
>Friday.  She has inverted nipples, therefore I have been prepping her and
>made sure she had a nipple shield at her disposal.


Jessica, inverted nipples can be a bit of a challenge, but a shield 
may not be the best first response. In particular, a shield can i) 
prevent a baby from learning how to bf effectively ii) reduce the 
volume of colostrum/milk available to the baby iii)  'hook' the baby 
onto a device

>  However, latching the baby
>on was challenging especially since all the little guy wanted to do was sleep
>after birth (to be expected).

No....it's not normal for babies to sleep a lot after birth. When 
held close to the mother, babies typically sleep intermittently and 
may feed very frequently for short times between times. Birth 
procedures and medications, and keeping mother and baby apart, may 
interfere with these normal responses.

>  He was born at 1:55 pm and didn't eat until
>1am.


It would be important to see why this baby did not want to feed for 11 hours.

>Of course I didn't want to leave until he was breastfed because I knew
>what the outcome would be.  YES... he was given formula *deep sigh*. 
>
>The mom was holding him yesterday and he began rooting, she lifted her shirt
>and he latched on, he had some trouble with out the shield.  She tried with
>the shield and he suckled for 10 minutes but the mom said no milk came out.


This could be a result of the shield - especially in the v. early 
days when there is colostrum which is lower in volume.

>We tried to manually express the first day and nothing came out.  I find it
>extremely strange that nothing came out when he was at the breast for 10
>minutes.

I would suspect i) the way you were trying to express was not quite 
right and/or ii) the baby had had the small volume available at that 
time (first day).  A better technique used again a few minutes later 
may well have retrieved colostrum.

>  I know she doesn't have a cork in her nipple and I have never heard
>of such a thing.  She said he was suckling and not swallowing and she saw no
>milk in the shield.    The mother feels that the extreme stress she undergoing
>may be the cause of the milk not coming out.  The stress is family related,
>throughout the ending of her pregnancy until now.  She is engorged, but no
>leaking and according to her no milk is coming out.

Maybe her let down is not working well because of stress, but you 
will need to make a judgement on whether there is 'nothing' coming 
out or not.

Jessica, I hope you are getting help with this, for your sake.....I 
think non-latching babies and worries about supply and milk being 
available to the baby are not the best situations for a peer 
counsellor to be involved with, except as a social support.  These 
situations are serious and potentially  risky for the mother, baby 
and for continued breastfeeding.  In the UK, there would be a midwife 
there and if available, a breastfeeding counsellor, too. In the US, 
would this not be the province of the IBCLC?

all the best to this mother and baby and you

Heather Welford Neil
NCT bfc, tutor, UK

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