Breastfeeding: Nipple Shields, Slow Weight Gain and Nursing Whilst Pregnant

When we initially discussed writing this blog, it was primarily to help other mums-to-be and new mums with breastfeeding. It can be so ruddy hard, especially in those early days and, if the support isn’t readily available, it is understandable that so many ladies switch to formula within days of their baby being born.

So, why has it taken us so long to post about our own breastfeeding journeys? The answer is fairly simple – breastfeeding remains one of the most divisive topics in parenting and we felt reluctant to write about something that always seems to create such controversy.

However, we’ve decided that, as we are both so passionate about breastfeeding, and ensuring mums (and dads) are adequately supported, and because this blog is meant to be personal, we will be covering it more. We aim to share advice and encourage mothers who want to breastfeed, and fathers who want to know how to help. We aim to bust (pardon the pun!) some of the ridiculous myths about breastfeeding, often perpetrated by people who are there to support – HVs, GPs and midwives. Read our ‘Disclaimer’ here for further clarification.

It is worth pointing out, before we share our stories with you, that we were both of the opinion when pregnant that ‘we would breastfeed if we could and not stress about it if we couldn’t’. With hindsight, we should have gone beyond the two hour NHS antenatal classes and attended some La Leche League meets on ‘Preparing to Breastfeed’ or visited a Breastfeeding Café to watch other mothers feeding and to chat with them. That way, the first few weeks may not have been such a shock…! This post was written with our pregnant selves in mind – hopefully it is of use.

Jo and Primrose’s Journey 

(I feel the need to refer to Primrose here as this journey is just as much hers as mine. When nursing, we create a dyad with our little ones – two beings becoming one – and that’s pretty special…)

In the Beginning…

After a fairly relaxed and pretty speedy waterbirth (read my birth story here, if you wish), Primrose was alert and latched on straight away. BINGO, I thought, she’s a natural! Wrong. This initial ‘great latch’ didn’t last long and we both became increasingly frustrated. The midwives at the Birth Centre showed us how to hand express and extract colostrum so it could be syringed into her mouth, then we were sent home, just hours after the birth. Suffice to say, my head was spinning – what if the hand expressing wasn’t enough? What if I couldn’t get anything out? Would she starve? This was before I knew how tiny a newborn’s tummy is and how little they take at each feed.

When the midwife visited on Day 1, she commented that she didn’t know why Primrose wouldn’t latch. However, crucially, I wasn’t offered a visit by the local Lactation Consultant, or given any numbers to call for advice. I decided that inverted nipples were to blame for her not latching. Rather than calling the LLL to discuss (I didn’t even know about them at his point), in my knackered state I sent hubby out for nipple shields and away we went – feeds took a long time and there was always milk EVERYWHERE but I was feeding her; she was getting that all-important colostrum. I felt like superwoman. For about two minutes.

Two days after giving birth, I had to return to the Birth Centre for an Anti-D injection. It was whilst we were there that my milk ‘came in’ and I immediately thought that it would encourage her to latch properly. Nope. So we continued with the nipple shields. On Day 5, the same midwife returned with the Lactation Consultant. In the four days that had elapsed, I had spent hours sobbing each night, telling the hubby to ‘go and buy formula’. It was only his refusal, knowing that I was, by now, resolutely determined to keep feeding her, that stopped me switching…

Rather than discuss with me the possible issues associated with nipple shields (milk transfer can be comprised, thus affecting supply, and therefore lead to weight issues), and suggest that I should begin each feed with them, before removing and getting her to try to latch without them, she simply said that Primrose was feeding ‘perfectly’. And that was that. No asking to check her latch, no offer to return another day. Nada.

Anxiety Ensues

What ensued were three weeks of me timing feeds, logging them in an app(!), obsessing over the fact she was having six feeds a day rather than the 8-10 (or more) that is *normal* for newborns and worrying about whether she was gaining enough weight. I’ve mentioned it in a previous post, but THANK THE LORD I discovered Gill Rapley’s ‘Baby Led Breastfeeding; it was my saviour. I spent a day in bed, feeding almost constantly and doing plenty of skin to skin. I realised that the advice we’d been given antenatally was, largely, outdated: waking babies up to feed them every three hours at night is unnecessary, unless they are poorly. New babies may well ‘feed consistently from 9pm-3am, when milk is at its richest BUT this can happen outside of those times too, and is perfectly normal!). I think it was around this time that I also discovered the La Leche League, plus two local breastfeeding groups on Facebook. They were brilliant!

Things were OK for a while, until I mentioned Primrose’s reflux to the doctor. We were prescribed Gaviscon. I pumped every morning to give me enough milk to give it to her. I then started to wonder why, if she was full on breast milk, why was she still taking milk from a bottle afterwards?! I knew nothing about the primitive ‘suck reflex’ that all babies had – they will continue to drink from a bottle if a teat touches their lips/the roof of their mouth as they have an inherent reflex that makes them! WHERE WAS THIS INFORMATION BEFORE I HAD HER? I know so many women who’ve stopped breastfeeding because “my baby was hungry – he’d guzzle a bottle even after a breastfeed”. Of course, in some cases this is true – if milk supply is low for some reason – but not in all cases. Why are these basic facts not being shared? Why are women not taught about paced feeding before being told to ‘top up’ with formula or expressed milk? Why are so many professionals happy to let a breastfed baby chug down on a crazy amount of milk without explaining to mothers how to mimic breastfeeding with a bottle? It makes me so angry.

Over the following months, Primrose’s weight gain was slow (but still – just – within the *normal* limits for a breastfed baby). Thankfully, I wasn’t told by any Health Visitors to top up or switch to formula, though I know plenty of women who have been. However, my anxiety increased and, rather than being told to STOP getting her weighed so frequently they encouraged me to keep coming back (every three days at one point). If she’d been losing weight, or had plateaued, this would have been fair, but she WAS gaining weight. My anxiety was at an all time high and every mention of weight gain by mum friends, or references to ‘my big, healthy baby’ on Facebook’ made me feel completely useless. It was this article that helped me to reframe the situation. Was she happy? Yes. Having a healthy amount of wet and dirty nappies each day? Yes. Bright eyed, clear skinned? Yes. I’ve lost count of the number of ladies I’ve passed this on to. Again, why is the information within it not widely distributed?

Bye, bye nip shields!

At 4.5 months, Primrose took matters into her own hands (quite literally). Obviously fed up with her fed up Mama and by the crazy length of our feeds, she knocked off a nipple shield at the beginning of a feed and completely refused to feed with them on. I panicked. These bits of silicone had become my security blanket – what if her latch still wasn’t right? Images of cracked nipples filled my brain and dusted off the lanolin cream… I needn’t have worried. Within a day or two, it was as though we’d never used shields and maaaaaan, was I glad to see the back of them! No more leaving them under friends’ sofa cushions or, more embarrassingly, wrapping them up in a birthday present by mistake (yes, really!).

I suddenly felt like I’d caught up with the rest of the tribe  who, by now, were feeding for shorter lengths of time and were able to lift up their top, let baby latch and feed without anyone even knowing they were feeding! I ditched the Gaviscon at the same time, wanting to get back to basics and not put anything in her tummy other than milk. I wish I’d done so sooner, though I imagine it was the shields that were causing the ‘reflux’ in our case – isn’t hindsight great?!

Having spent the last four months thinking ‘get me to six months so I can stop breastfeeding’, it had now become a pleasure. The time we spent nursing was calm and precious, and I had a guaranteed tool for getting Primrose off to sleep, soothing her when she was teething and knew that both of us were benefiting. It was so easy when we were out and about or on holiday. Plane journeys were a breeze – I could feed her on take off and landing to help her ears regulate, and the 11 hour night flights to Cape Town and back were actually spent sleeping! When the weather got warmer last summer, I knew she was hydrated enough and am now missing it in the hot weather – chasing a toddler around with a cup of water isn’t much fun at 7.5 months pregnant!

Getting Political…

By this stage I’d done a lot of research not only into the benefits of breastfeeding for babies and nursing mothers, but also into the unethical advertising tactics used by formula companies and their aggressive marketing of formula in developing countries where the water makes it unsafe for babies. The crux, for me, is that they are entirely happy to let women believe that her body isn’t geared up for breastfeeding, playing on the exhausted, vulnerable minds of the new mother, making her believe that she is incapable of feeding her baby herself. Or fuelling society’s expectation that women get ‘back to normal’ (ie: stop breastfeeding) as soon as possible. For the 1% of women who cannot physiologically feed, these companies have their place – formula is, unquestionably, a life saver for these babies – but for the majority, the choice is made for them via unregulated advertising and the £billion industry whirring away. This article by Dr Amy Brown at Swansea University covers things in more detail. Whilst I would use formula in a heartbeat if I was somebody who couldn’t physically breastfeed, I personally didn’t want to fund them if I didn’t have to.

So I aimed to continue for at least a year. Then September 2016 came and went and, suddenly, we were in ‘extended breastfeeding’ territory. This term irks me, too – if the WHO recommends feeding for 2+ years, why does it suddenly become ‘extended’ after a year? Yet another label to pin on mothers who want to continue feeding.
By around 14 months, nursing had become a ‘one extreme to the other’ situation. During the day and at night, she never wanted to feed but for naps and bedtime, it was still her go to. The exception was a nasty tummy bug when all she wanted to do was nurse, and I was thankful I could still provide that comfort and that my milk would adapt to provide an immune boost for her. It wasn’t ‘easy’ all the time – I experienced blocked ducts on the same side at least 10 times throughout our journey. Thankfully, with heat, massage and lots of feeding, I managed to keep the dreaded mastitis at bay each time.

Periods and Pregnancy

As our number of nursing sessions each day reduced, my period returned (deep joy after 23 months without them). Within a month, I was pregnant with number two. Over Christmas, I felt so sick, nursing felt like a burden for the first time since those early days. I felt mild nursing aversion and had to try hard not to get frustrated – it wasn’t Primrose’s fault I felt this way. I’d read that many women find their milk dries up at around 4 months due to hormonal changes but was prepared to continue throughout pregnancy and to tandem feed both babies when number two arrived.

At four months pregnant, when Primrose was 17 months, she started feeding for less than a minute each night, having dropped her nap feed a week or so earlier. I panicked about getting her to sleep and the fact that she was sleeping 12 hours each night – what if everything changed?! Fortunately, the very same week, my lovely friend Marneta at Relax Kids sent me this CD to review for the blog – the effect was something akin to hypnosis and Primrose was happy to ‘duggle’ to sleep, drifting of to  the music. Now, if she sees me with no top on, she points and says, “nips” or “nipples”. Worryingly, she referred to them as ‘ears’ at one point but I’ll let that one go 😉

Whilst part of me was sad not to let her self-wean in the proper sense, I was pleased to make it to 17 months, especially after a challenging start. It was also a relief that Primrose didn’t seem fazed by the end of our journey – it will be interesting to see how she reacts to seeing her little brother feeding in a few months.

For us, breastfeeding meant a close bond – in those tough early days, it felt like we were a team and, as I’ve heard other women say, it forced me to slow down and just ‘be’ in the moment. As I began to enjoy it more, it helped shape the way I mother – I’m naturally quite a ‘busy’ person, and can get easily frustrated, but it forced me to be responsive to Primrose’s needs and let her lead me. It also meant I could feed wherever, whenever, which is great news for someone who regularly forgets to pack stuff! I had the amazing support of my husband which, along with a tribe full of breastfeeding mamas, undoubtedly made things easier. There’s no question that, for the first weeks (or months, in our case), breastfeeding can be tough – it’s a skill that needs to be learnt by both of you. I wish I’d been prepared more before giving birth, and that I’d known about the LLL. I also wish I’d had a babymoon in the week or two after Primrose arrived – no visitors, no going out, just chilling, feeding and doing skin to skin but, again, hindsight is a wonderful thing.

My biggest piece of advice? If you’re finding it tough, seek help right away: the NCT, your midwife/HV, breastfeeding peer support at your hospital, local breastfeeding groups and, of course, the LLL – look online for your local group and leaders, who will be contactable by phone and often offer home visits too… put your pride to one side and let them take a look at that latch! One simple tweak to positioning or hold and any issues may well be gone. I’m hoping to train as a La Leche League Leader at some point in the near(ish) future. I’m indebted to them for the support they offered and would love to pay this forward and help other mamas.

Check out this page for additional recommendations for helpful online groups.

Jo, The Mother Side xx

Cover photograph by Dekker Photography.

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3 thoughts on “Breastfeeding: Nipple Shields, Slow Weight Gain and Nursing Whilst Pregnant

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