Breastfeeding/Lactation Consultant

The Haberman and finger feeding both provide some pretty firm stimulation to the roof of the baby's mouth.......more

Babies frequently have a tough time trasitioning from the firmer stimulation of bottles, finger feeding, and/or pacifiers to the softer stimulation of the breast. This can be especially pronounced if mom has flat or retracting nipples that seem to "shrink" away from the baby. The reason for this tough transition is b/c the baby needs to feel the sensation of the nipple on the roof of the mouth back at the juncture of the hard and soft palate to stimulate a good suck and to maintain a good suck. That spot I'm talking about is very far back in the mouth, if you suck on your thumb and allow the tip of the thumb to go as far back as it can go without gagging yourself you have just found the spot I'm talking about.

The first thing I try in this situation is to have mom compress the areola close to the nipple, really almost at the spot where the baby's lips need to go, they will be touching the lip if the baby latches. I have mom hold this compression until we are sure the baby is into a good strong suck pattern for a little bit, then the mom gradually releases the compression. As the baby matures she can hold suction on the nipple and keep it against that spot on the roof of the mouth. Of course good position and latch technique are vital too and making sure the baby latches with a really wide open mouth (like a yawn) to ensure a big mouthful of breast tissue.

Here's a post on basic position and latch:

http://boards.parentsplace.com/messages/get/ppbreastfeeding77/45/1.html

It would also be very important to find an experienced lactation consultant who can see you in person. Here is how to find an LC:

http://boards2.parentsplace.com/messages/get/ppbreastfeeding176/11/1/1.html

Also, try to make the feeding sessions as calm as possible. If the baby is fussing don't try at the breast at all. Offer some bottle first and then when the baby is calmer try the breast. You may need to begin by offering the breast when the baby is almost finished the bottle and then at the half way point, and then after just a small amount on the bottle before the baby will take the breast to start. The Haberman is not really different than other bottles in regard to the sensation it provides in the roof of the mouth. The only thing that is different is that you can control the flow of milk and make it slower or faster. Try to mimic the breast by offering the Haberman with the slower flow at the start then increase the flow and then slow it again as the breast will do so the baby doesn't always expect the fast flow regular bottles provide.

I hope you are using a rental pump, they are best in this type of situation.

Try to do your bottle feedings in a bf position and put the baby against your bare skin so he starts to associate that with being fed and with pleasurable sensations, not the struggle to latch.

Only attempt latch for 5-10 minutes or even less if the baby is fighting against it. Don't make feeding sessions into a battle, the baby must be comfortable or it won't work.

So your feeding plan would go like this. Offer the breast first only if the baby is receptive and calm. If he doesn't take the breast after about 5 to 10 minutes or if he gets upset, offer about 1/2 of the amount he normally take from the bottle then try at the breast again for 5 to 10 minutes or stop if he objects. Finish the feeding with the bottle if he never latches. If he does latch offer soothing, quiet, verbal encouragement and allow him to suck as long as he wants and it is comfortable.

Most of all get an experienced LC to see you in person. Ask if she has had good success getting babies from bottle to breast before you agree to see her.

Please be sure to get back with updates and more questions as needed.

Warmly Kathy

Thanks, Kathy! Sounds like what we are doing (m)

You are right about the stimulation of finger and bottle nipple--that was the only way I was getting him to suck anything earlier. Did I mention he was gaggy his first day or two? Even the finger or bottle he doesn't go for right away, so at least he doesn't seem to show a huge preference for that feeling in his mouth. I think it's helping having him associate strong sucking with milk flow, and the Haberman is helping with that (I keep it on medium flow most of the time).

I'm just going to have to be patient with this. I think the advice of not letting nursing sessions become frustration sessions for both of us is very good (wish I'd know that earlier with my twins). The book I'm reading, "The Ultimate Breastfeeding Answer Book" says it can take 4-8 weeks for reluctant babies to latch? Similar advice in that book, too.

Thanks for the advice; I'll keep you updated! We are also going to try cranio-sacral therapy on him. Can't hurt, might help.

Sarah and Nate