HOW DOES ONE TRANSITION FROM USING PRODUCTS TO BEING ABLE TO NURSE WITHOUT THEM?
Start by remembering that infants have a very strong urge to suck.
Their sucking instinct and their hunger are 2 desires that can be used to help wean babies from bottles and other artificial nipples.
The more a baby uses products for feeding; bottles, nipple shields, SNS (Supplemental Nursing System), or finger feeding with an SNS tube, the less interest he will have in natural breastfeeding.
Babies often develop a preference for artificial nipples if they are used in the first 6 weeks of life.
Warning: some babies will refuse the bare breast if they have been given artificial nipples in the first 6 weeks.
The good news is that the fewer products he uses, the shorter the period of time that he has used them, the more interest he will have in natural breastfeeding.
SNS - Supplemental Nursing System
We have seen many mothers sold these devices to help them transition from bottle to breast.
An SNS is a bottle with tubes that are taped to the breast.
The idea behind using an SNS is that when moms are trying to increase their milk supply, baby sucks the breast and gets milk from the tube, while also stimulating the breast to make more milk.
In theory it sounds like it should be helpful. But moms often complain that the baby is sucking on the tube and not the breast.
Sometimes moms or dads will tape the tube to their finger and have baby
'finger feed'.
This is not getting baby back to natural breastfeeding.
It has introduced another product that needs to be kept clean.
To wean from bottles takes a bit of behavior modification;
We recommend the Eyedropper Method
We recommend the Eyedropper Method instead to transition from bottle to breast.
Baby must eat one way or another.
To ensure that baby is getting enough to eat during the transition from bottle to breast, a clean plastic eye dropper or syringe can be used.
Eye droppers and syringes are available in pharmacies.
This is a transitional process. It should not be done for very long.
It is messy sometimes, but it is temporary.
The Eye Dropper Method looks like this:
Baby is refusing the breast in the early weeks; Mom has been pumping and baby is getting bottles of expressed milk.
Mom wants to breastfeed, not bottle feed.
Try the following for a period of 5 or 6 hours.
-Continue to pump and feed the expressed milk or formula in an
eye dropper or syringe.
-Do not use bottles during this 6-hour period.
-Gently place eye dropper in the side of baby's mouth.
-Squirt milk into mouth.
-Remove eye dropper from mouth.
-Keep giving milk until feeding is over.
-Do not let baby comfort suck on the eye dropper.
-Hence, baby will be fed but his urge to suck will not be satisfied.
-Hold off pacifiers at this time.
-Hold baby close to breast between feedings.
Offer breast if he is interested, in the Cradle Hold
(or Lap Nursing Hold) position.
Give lots of skin to skin contact with Mom.
-Baby may be interested in the breast because his desire to suck has not been satisfied with the eye dropper the way it was with a bottle.
-Look for any interest in the breast in the 6-hour period.
Look for progress, not perfection...
-If he is willing to latch on and nurse and mom has a good milk supply, congratulations!
-If he is not willing to nurse, try again the next day.
-Feed with bottles until the next day, to make sure baby is keeping his strength up.
The idea is to NOT exhaust baby or parent during this time.
It can be stressful on all concerned.
Some babies can go 'cold turkey' to the breast with this method and eagerly accept the breast. Others will need a more gradual transition that includes bottles in addition to the eye dropper feedings and the nursing at the breast that he is willing to do.
Each situation is different with regards to weight of baby, willingness to try the breast, milk supply, breastfeeding history, etc.
We recommend that you:
-Count wet diapers and bowel movements during this transition process.
Baby should have 5-7 wet disposable diapers or 6-8 wet cotton diapers
with 2 or more bowel movements on those wet diapers, in
every 24 hour period.
-Watch for warning signs that he is not eating enough such as excessive crying or lethargy.
-If this happens feed him more by whatever method he will take!
Parents need to make sure baby is eating enough as baby transitions back to the breast.
Once baby is interested in nursing at the breast, mother can reduce the number of times she pumps each day and the length of time that she pumps each time.
If mother is pumping often, it can interfere with mom having a fuller breast when baby is ready to try to breastfeed.
This is another part of the transition process that must be balanced, how quickly or slowly to stop pumping.
For example: If mom is pumping 4 times a day, and baby is nursing at the breast again, try eliminating one pumping session and count his diapers for the next 3 days. If he is still having 5-7 wet disposables and 2 or more bowel movements in every 24 hour period, then he is getting enough breast milk. Try eliminating another pumping session, count his diapers, and so on.
Baby's health is the top priority. Make sure he is eating enough and slowly you will be able to stop pumping and breastfeed without bottles or products.
To Recap:
What happens with the eye dropper method is that the baby's urge to suck is not satisfied, as it is with the bottle.
Baby is getting food but his urge to suck is not satisfied with the eye dropper. After some feedings with an eye dropper, he will be more interested in nursing because nursing was created to satisfy that urge to suck.
Mother can watch baby's clues to find times when he is more willing to try to nurse. Sometimes a baby will nurse in the middle of the night but not during the day if he's awake and hungry.
Try offering the breast when baby is sleeping in your arms or as you walk around the house. Sometimes babies will latch on if mom and baby take a bath together.
Holding baby close, giving lots of skin-to-skin contact, often encourages a baby to want to nurse.
Breastfeeding only in one of the positions that help; the Cradle Hold, Lap Nursing Hold, or Lying Down positions, will help baby to learn more quickly.
Using any of the HSH positions will often cause problems. We do not recommend the Cross Cradle Hold, Football Hold or Log Hold positions.
Some babies transition away from products slowly, but we have seen it work many times!
Once baby does latch on in the Cradle Hold, let him nurse for up to 20 minutes per side so that he gets a good learning session in.
Switching sides after 15-20 minutes is recommended. Nursing for longer than this, usually in a burst of enthusiasm for finally getting baby back to the breast, can cause sore nipples.
If baby wants to keep nursing, switch sides every 15 minutes or so.
Drink lots of pure water while nursing, before nursing, and after nursing.
If your mouth is dry, you are starting to get dehydrated. Please drink.
Mom's milk flows more easily when she is drinking enough water.
It may seem like baby is nursing all the time when he transitions back to the breast, in the Cradle Hold position.
This is good news! What he is doing is building up the milk supply to fit his needs, so that supplements and pumping will no longer be needed.
This is the Supply and Demand Mechanism of breastfeeding in action.
Baby will marathon nurse for a few days to build up the milk supply to fit his current needs.
He will demand more milk by nursing more frequently and for longer periods of time.
The supply of milk increases. Supply has met demand!
Once this happens, he will nurse less intensely.
How to wean from nipple shields.
CAUTION - Nipple shields are not recommended.
Nipple shields are another product that has been heavily promoted since the introduction of the Cross Cradle Hold.
When moms have sore nipples, lactation personnel usually offer nipple shields instead of teaching them the Cradle Hold position.
Nipple shields are silicone or rubber pieces that fit over mother's nipple.
Baby latches onto the nipple shield instead of mother's bare skin.
Baby's sucking pulls mother's nipple into the nipple shield. This can irritate mother's nipple.
Nipple shields need to be kept clean. Cleaning shields is time consuming, at a time when baby needs mom.
Nipple shields can interfere with mother's milk production.
When a baby latches onto a bare breast, mother receives sensations that tell her to let down the milk and to make milk for baby.
With the nipple shield covering the breast, mother's body does not receive as much stimulation.
Mother may not be receiving the amount of stimulation needed to produce enough milk for baby's needs.
Nipple shields interfere with establishing the optimal microbiome for babies.
From: JAMA Pediatrics, 2017, 'Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome', by Pannaraj, Li, and Cerini.
This study showed:
'... breastfed infants received 27.7% of their gut bacteria from breast milk and 10.4% from areolar skin during the first month of life...'
This study was done to 'determine the association between the maternal breast milk and areolar skin, and infant gut bacterial communities.'
'Establishment of the infant microbiome has lifelong implications on health and immunity. Gut microbiota of breastfed compared with nonbreastfed individuals differ during infancy as well as into adulthood. Breast milk contains a diverse population of bacteria, but little is known about the vertical transfer of bacteria from mother to infant by breastfeeding.'
The results of this study show that areolar skin cells are part of Nature's plan for the baby's microbiome.
Nipple shields interfere with the baby receiving the skin cells from the areola,
as baby will only have the nipple shield in his mouth to nurse. He will not receive any of the mother's nipple or areola cells as they are covered by the nipple shield.
He will receive the mother's milk, but not the areola skin cells.
This was not nature's intent.
Nipple shields can be hard to wean from.
Babies get used to the harder nipple shield and often will refuse the bare breast.
The longer nipple shields are used, the less likely it is that baby will nurse without them. But I encourage you to keep trying, nursing is so much easier without nipple shields.
Try slipping the nipple shield off once baby is nursing.
Keep offering to nurse without the shield throughout the day, in the tub, during night feeds.
Don't try cutting pieces from silicone shields because sharp edges may be left.
If baby is used to nipple shields and pacifiers, try offering him a clean finger, with a trimmed fingernail, to suck on. This may help him get used to skin, versus artificial nipples.
I ask; where is the long-term research proving that the chemicals, including silicone and other materials used in nipple shields, are safe for infants?
And, what are the effects on the baby's microbiome when nipple shields block baby from getting the mother's areola skin cells?