Weaning off nipple shields

As a midwife I was surrounded by breastfeeding and supported lots of clients to breastfeed. When finding out I was pregnant I knew I wanted to breastfeed and tried to optimise my chances. I took a course with my partner to refresh my mind,harvested colostrum and didn't buy any "back up" formula.

My daughter was Breech and stayed that way in utero until her birth. I knew I'd be offered an elective but tried for a vaginal birth which unfortunately did end up in an emergency caesarean. My daughter was placed in skin to skin in theatre but it didn't feel like long enough for me and felt like a tick box exercise.

I was unwell during my stay in hospital, I had Covid and so my partner couldn't be with me postnatally and the staff members weren't keen on coming into my room frequently because of all the PPE they had to put on.

This meant no one was there to pass me the baby and help assess her feeding. I was frustrated and knew something wasn’t right, I knew how to position her but it was painful.

I didn't receive any support in hospital and they were very dismissive of my instincts over her feeding and the latch being painful. I self discharged after 24 hours so I could be at home with my partner and get some support elsewhere.

The community midwife then didn't want to visit either because we had Covid and so did a telephone consultation instead. I was getting desperate and knew time was crucial in getting my milk supply in so was hand expressing colostrum and syringe feeding it to my daughter every 2 hours.

My nipples were shredding and sore, I knew she had a tongue tie but was hesitant as the NIPE Midwife had dismissed me. She was gaining weight well but I couldn't continue with the pain. I purchased nipple shields on Amazon prime and they came the next day. Finally she was feeding at the breast and it felt like such a relief.

My daughter was born over Christmas and getting support was difficult. I had to go private to get her tongue tie assessment done by a private practitioner. I wish I had done more research as the professional who diagnosed a posterior tongue tie with 85% restriction snipped it but then didn't provide any feeding support. I carried on using the shields and she wouldn't latch without. I contacted three IBCLCs; with the first one she latched! Fed like a dream but when the lactation consultant left and we were alone together I just couldn't get the latch right, I could feel her gum line pinching my areola and it was burning. Back went the shields and we'd try again.

The third lactation consultant came and told me that the shields weren't a problem, she'd had a client who had fed for years with them. She recommended doing one feed a day without them on each breast and to try later on when she was bigger and the latch "didn't matter as much".

At the time this felt reassuring however because the shields didn't enable my daughter to have a deep latch she was shallow, she swallowed a lot of air, arched her back, was uncomfortable and developed silent reflux as a result.

She had lots of tension (from being Breech/ from the tongue tie) but equally from compensating using her cheeks and lips to feed with rather than her jaw and tongue. My nipples began to feel uncomfortable they were pinching when using the shields.

I got my daughter's tongue tie reassessed this time by Carmelle Gentle who is a wonder woman. She helped immensely, releasing some of my daughter's tension and gave me some exercises to do. We went to the osteopath to help further but she was still feeding 24/7 for hours and hours. I kept getting told this was normal and cluster feeding and newborn behaviour to be expected but it just didn't feel right.

I dreaded every feed and suffered with something called DMER every time I fed her I didn't feel a rush of love, I felt like the end of the world was going to happen or a fire or I would invision falling asleep holding her and her not waking up. I was so exhausted trying to get her to sleep one morning I fell over a tree root with the pram and badly hurt myself. I wasn't healing from my caesarean and kept getting told to just give her a bottle or stop complaining.

What I'm trying to say is, I had exhausted all options and wanted to give up. I went to the GP and they gave us gaviscon. I wasn't comfortable giving her medicine as I knew it wasn't the root cause. I also (being that over researching midwife that I am) googled the NICE guidelines in the waiting room and saw that a "feeding" assessment was the first line of action with infant reflux.

Clearly the GPs interpretation of assessment was different to mine. He just asked Breast or bottle ? I left feeling deflated and like I was actually going mad. The amount of gaslighting that was going on and dismissing of my concerns just left me in tears.

I opened Instagram up and up popped a post from Mother Shaheda. I had been an avid reader of her posts and often sent links to her posts to other mums in my WhatsApp group.

I quickly emailed her and asked her if she would be willing to help and if there was anything she thought she could actually do. I might have been a bit blunt and given her my whole life story but I was so frustrated at paying all these Lactation Consultants who charged over £100 per visit to then not make any progress.

Shaheda replied instantly asking for my address, more information and what exactly I wanted help with. I felt so validated and listened to. She came the next day, from one end of London to the other. She observed a feed with the shields and without, quickly guessed I was a Midwife and got straight to work. My daughter latched easily without the shields, Shaheda was kind and patient, she watched us feed and told me what to look out for when the latch was good and asked me frequently if I was in any pain or discomfort.

There were times she slipped into a shallow latch but Shaheda reassured me just to take her off and try again. She gave a rationale for everything which eased my anxiety and made me understand what was happening. We stayed in touch over WhatsApp because I had tried several times before to remove the shields but felt nervous if the latch wasn't effective and will affect my daughter from thriving. But she gave me rationale as to what was happening which made me see sense, relax me and manage my expectations.

Shaheda messaged me back promptly and always cheered me on. I continued without the shields and got her weighed for extra reassurance. I realised that going back and forth with the shields was actually confusing my daughter's latch. The techniques used for her to latch with a shield and a deep latch on the breast without were so different. Because of the silent reflux due to the shields she fed so frequently in a viscous cycle, but this resolved after my milk supply regulated without the shields.

This Sunday will be 5 months of exclusively breastfeeding my daughter and I cannot thank or recommend Shaheda enough. The nipple shields if you've seen from her stories went in the bin and never went back on. Sure I've had moments where I would have reached for them, teething, rubbing gums on me, a shallow latch from time to time due to positioning during night feeds or not repositioning her as she grows to ensure the latch is optimal.

Shaheda is incredibly skilled, kind and knowledgeable. She is generous with her time and that is because she genuinely is invested in the care that she gives. I could can see how passionate she was when she was providing me with support I've never seen someone so excited by a latching baby we both shared the joy in those moments, together with my partner who was just as relieved to see I'd found someone who didn't think it was all going on in my head.

If I could pass on one bit of advice to anyone preparing to breastfeed it is to trust your mothering instincts and to shout loudly when something doesn't seem or feel right to you. Please don't suffer in silence or put up with the uncomfortable. As women in society we are often told to keep quiet and carry on. Breastfeeding my daughter was about was more than milk I am incredibly grateful for the bond I have with her and I have Shaheda in part to thank for that.