Just had to respond to Rachel B's concern with the use of nipple shields for
her cousin.
From information given, the care provided by the LC's (IBCLC, I presume)
sounds appropriate. If nipples are inverted, short, flat, soft, whatever
and baby cannot latch well, nipple shields may be used to get baby on
breast. If baby cannot get on breast, he cannot breastfeed.
If baby is not breastfeeding, milk has to come from somewhere. If baby
cannot attach to breast, SNS cannot be used. Baby still has to eat.
Sometimes the SNS can be used with the shield if the mother wants to do so.
Most of the mothers I see do not want to use it. Maybe a cup feeding or two
will perk baby up to be able to attach to the breast even with nipple
condition, maybe not. Baby still has to eat. Cup feeding over a long
period of time may not be the best since baby still needs to suck and cannot
get on breast to do that. Avent bottle is one option. I find less problems
using it than with finger feeding.
It is very, very true that baby will follow the milk. Slow/low milk and
there will be difficulty with nursing even if nipples are not inverted.
Milk flow may be the problem in this case, not nipple confusion. What
bottle was used?
So....what are the goals? Keep milk flowing. Mom must pump (this aspect
of the care plan was not mentioned). Baby must eat. The two can be put
back together later if need be; however, from the information on this case,
baby did attach to breast with shield.
Cousin's care plan could include interventions to get supply up; Breastfeed
using the shield until baby no longer needs it; Supplement with Avent as
needed; Frequent follow-up and feeding assessments with IBCLC until
difficulty resolved.
I have seen use of the nipple shield protect many mothers from breastfeeding
failure.
Pardee Hinson, MPH, IBCLC
Carolinas Lactation Center
Charlotte, NC
[log in to unmask]
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
