Northside Hospital - Special Beginnings

NIPPLE SHIELDS • A thin silicone device that fits over the nipple.

• Needed if baby slips off the nipple or can’t maintain suction. • Helps premature babies stay attached longer and transfer more milk. • Place over the breast so nipple fills the chamber of the shield. • Position baby so nose is over the cut out part of the shield. • Guide the nipple over the baby’s tongue. • Keep baby’s lips flanged out over the base of the shield. • Tip of the shield should be in the back part of the baby’s mouth. • The firmness of the shield may increase the sucking reflex. • There are different sizes of nipple shields and a lactation consultant can assist you in finding the right size.

Nipple shields are intended for short term use and many moms are able to stop using them once the baby is home. It is important to work with a lactation consultant when using the nipple shield as a tool with breastfeeding.

ENGORGEMENT Your breasts may become heavy and swollen 3 to 4 days postpartum. This is caused by an increased flow of blood to the breasts, swelling of the surrounding tissue, and the accumulation of milk. The breasts will be swollen and uncomfortable for some women, and you may experience a throbbing sensation and discomfort with the milk ejection reflex, or let-down. Some women will feel only slightly full. As with labor, all women are different in their experiences. Breast swelling usually lessens within 1 to 2 days. Some effective treatment measures for engorgement: • Pump/breastfeed frequently. • Breast massage has been shown to reduce engorgement . • Apply cold compresses to the breasts after pumping or feeding. Use a frozen bag of peas or corn for 15 to 20 minutes. This triggers blood vessels to constrict and helps with swelling and draining and soothes any discomfort. Never apply an ice pack directly on the skin.

If your baby is breastfeeding: • Manually express or pump out milk to soften the areola and nipple. It is sometimes hard for the baby to latch-on if the breast is too hard. • Warm compresses before feeding can relax the breast and encourage let-down.

Allowing yourself to become engorged beyond the initial breast swelling associated with milk surge should be avoided if at all possible. Engorgement sends signals to the brain to slow down milk production and can cause other problems. As mentioned earlier, milk production is regulated by supply and demand. If you slow down your feedings/pumpings, you will see a significant decrease in your milk production. If you need more information or assistance on expressing breast milk, call your health care provider or lactation consultant.

Special Beginnings in the Special Care Nurseries

35