Ask Judy: Does My Son Have Nipple Confusion?

My son has been supplemented with the bottle pretty much since birth. I let his dad help me with feedings. We have used the same slow flow nipples this whole time. He hates any other nipples. I had been pumping and he did pretty well latching on as well. At our night feedings and the first one in the morning while lying in bed he does great still, but any other feedings he gets so angry. He wont even try to latch on for more than a second. Sometimes I hand express to get it flowing, but even after it is flowing he is so angry he just wont take it.

I am working now, and pumping but I don’t make enough milk anymore to satisfy him completely so he is being supplemented with formula now. I am only able to get about 4 ounces pumped on a typical work day. He is probably about half and half on breast milk and formula right now.

Its just slowly but surely we add one more formula bottle and one less breast feeding about every week or so.

He gets so angry when I try to feed him that it stresses me out so much. I have tried so hard. In the beginning I had cracked scabbed nipples and had to use a nipple shield. It took me a while to get him to latch on without it, but finally he did. Then, my milk supply was slow and I pumped and pumped to get it up to enough for him, and now this. He seriously throws such a tantrum and kicks, and scratches and flails about when I try to put him on the breast. He screams bloody murder so I just give up because it is really hard to handle. I am just sadly giving up. I am going to try to breastfeed at night and first thing in the morning still, but the other feedings are just going to have to be what I pumped from a bottle and formula until my milk dries up completely. Do you have any advice or suggestions to help out?

You are doing such a great thing for your baby. The last thing you should feel is defeated. Be proud of all that you have done. Having to supplement isn’t the end of the world, but let’s see what we can do to get you breastfeeding again.

It sounds like he has nipple confusion. Lots of times babies will go back and forth to the breast and bottle when they are little, but they slowly develop a preference for the bottle. The milk comes out faster from the bottle than the breast and they don’t have to wait for a let down. I would recommend that you continue to breastfeed him during the times that he will accept it (night time, early morning). To get him to nurse more at your breast, I would say start using the nipple shield again. It is easier to carry around a nipple shield than a breast pump wherever you go – so if you can get him to start taking his daytime feedings using the shield, that will definitely make you feel better and should also help your supply.

I would start trying to use it when he isn’t super hungry – before he starts showing all of the classic signs of hunger – that way he will be more patient and won’t be so frustrated trying to get the milk. I would also hand-express or pump to get your milk flowing the first few times you use the shield with him so that he doesn’t get frustrated waiting for your let down. The shield will “feel” more like the texture of the bottle – so even though you spent a lot of time trying to get him off of using the shield – I think that using again is going to be your best bet for getting him nursing and being happy about nursing.

The more you can get him nursing, the better it will be for your supply (not to mention the convenience of not having to pump when you aren’t at work!). You can find some great tips for pumping and increasing your supply in my Pumping Tips article. I’d like to highlight a few of them for you:

• Pump for a full 15 minutes – even if nothing is coming out – the added stimulation is good for building up your supply
• When you pump – try pumping for 10 minutes, turn the pump off for 2-3 minutes, then pump for another 5 minutes. This ALWAYS gave me a second let-down.
• Be consistent about the times that you pump – try to pump at the same time every day so that your body realizes that this is a time to make more milk. You should start to notice an increase in production just because of regular pumping.

Since your supply is already low, I would also recommend that you take an herbal supplement. The best thing is a combination of Blessed Thistle and Fenugreek – you can buy it in liquid form at Whole Foods (or other natural food stores). It is worth it! You will know you are taking enough when your skin smells like maple syrup. Take a look at my blog post on fenugreek for more info.

I think you are doing a great job! Don’t give up and don’t feel bad – you are doing such a great thing for your son. Even if you always have to supplement – the breastmilk he is getting is so good for him and so good for you! I think if you try some of the tips above, you will notice an increase in your supply and hopefully you will be able to get your son latched on again. Don’t expect immediate results – it is going to take patience and time. And the best thing to do is to stop when you and your son are getting frustrated. You don’t want breastfeeding to be a negative experience for him. But keep trying and be persistent and eventually you will make progress and he will start nursing again. Don’t feel defeated and keep trying – those are the two most important things.

Please email me anytime and let me know how it is going. I will be sending positive milk vibes your way!

Judy

Has your baby had nipple confusion? How did you get them to nurse again? Please share your experiences!