Dear Nikki,
I hope I can get this right, word it in a way that will make sense to  
more people than just me!!
First of all, let me state; I am a believer in the intelligence of  
the newborn, and they sometimes get here angry. I love s2s, cranial  
work, and watching, listening to baby's cues.
Sometimes, I think they aren't quite ready to be here and are a  
little confused by all of their new surroundings. With these babies,  
I swaddle them and have the parents hold them tight. I would love to  
swaddle these babies in something dark red or purple, the colors of  
the womb, but it isn't always possible. I also use a nipple shield,  
if needed, for 2 reasons; 1. It is very distinctive and obvious which  
may be all the encouragement the baby needs to start recognizing food  
sources. 2. If latch is a problem, it is an easy tool to use to teach  
the baby to open wide and hold on tight!
I have heard many times about supply issue and nipple shields (save  
the letters!), supply is not an issue in the first few days PP as  
lactogenisis 1 takes place as a response to the delivery of the  
placenta, NOT stimulation so the nipple shield in the first 3 days is  
a great non-invasive, non-traumatic way to get the baby to the  
breast. A confused/angry baby will grab onto a shield rather quickly  
and suck and calm down. Please, what is more important? A crying baby  
or a happy baby? If, after a few days, we need to get rid of the  
shield, it is easier with a baby who now feels secure and safe.  
Sometimes I will teach finger calming with a big finger placed well  
into the baby's mouth. Why? Because the babies 'get it'. They  
realize, 'oh, something is in my mouth, suck, oh suck, oh, I get it,  
SUCK. Oh, that feels good, that feels comforting. Finally these big  
people are figuring out what I need.' These tools can often times get  
these new families over the traumatic part quickly and easily and  
give everybody some time to heal emotionally and physically. Which,  
in turn gives them more strength to face the next hurdles with more  
confidence and less fear.
I have been using nipple shields for years and truly believe, when  
used properly, they are one of the greatest tools ever invented  
(sorry Jack, it's true). Have I ever seen them compromise a milk  
supply? Yes, twice. But, pumping wasn't helping either, nor was the  
crummy latch the baby had without the shield. That is why I am  
vigilant when they are used. Have I ever seen them save a  
breastfeeding career? YESSSS many, many times WITHOUT compromising  
the milk supply and the babies transition off of them with ease.  
Nothing will stop me from having them as a part of my 'bag of  
tricks'. I would be lost without them and my clients would suffer  
harder and longer unnecessarily. "First do no Harm". Some of these  
babies have been so traumatized during their long and arduous  
'assisted' births, they can't latch properly, they won't latch  
properly and the latch cannot be fixed in a day. I need a quick and  
easy 'stop-gap' measure until some sort of normalcy returns.
Sometimes, they cry a bit when first swaddled but they tend to calm  
and latch when they wouldn't latch with s2s. The last client I had  
with this kind of baby had a NATURAL birth. It took SIX weeks to get  
everybody on track. I pretty well had to break out every trick I know  
and spent hours and hours with them either in person or on the phone.  
The parents would tell me "she hates being swaddled" but she hated  
flailing and screaming more. At 6 weeks she is (they all are) AMAZING  
in their lives. Mommy has a full supply of milk, no shields, latches  
like a champ and NOONE is crying any more!! It is a sight for sore eyes.
Please don't underestimate the value of swaddling a disorganized/ 
angry/confused newborn. When they are calm or sleeping, it is a great  
time for s2s. Sometimes, tincture of time is the best healer and  
doing whatever humanly possible to get these babies to feel safe,  
secure and not crying. IMHO a crying, flailing baby is a big red  
flag. A red flag not to be ignored. Maybe wrapping the baby to the  
mom or dad would help these babies to feel secure and accomplish s2s  
at the same time. I think too much room to move is very scary for  
these little ones. I watch their little hands, feet and brows for  
signs of relaxation and security. When I get these positive signs, I  
know I am on the right track and I encourage the parents to continue  
in that mode, whatever it may be, until it becomes VERY obvious the  
baby has recovered from whatever set her/him off in the first place.
We need to ease this transition from 'free womb and board' to 'will  
work for food' for these little guys. That is my goal. These tools  
are what work for me.
Cheers,
Annie VerSteeg IBCLC

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