Notes on the nipple shield

Feeding is hard, they said.

I was sitting in the nursery, in the padded rocking chair I had found secondhand online, to have a dedicated place to breastfeed, wearing the robe I had bought, to make doing so easier. My five-day old son was curled up asleep on my chest, his little scrunched up legs resting atop the nursing pillow a cousin had purchased for me from my registry. My husband came in and sat down on the padded, upholstered stool I had acquired so that he could keep me company during the many hours I expected to spend nursing and told me, in the gentlest tone he could muster, that I “did not need to be a Goop mom.”

I heard him say these words and I knew what he meant. I did not need to have a “natural birth” or exclusively breastfeed to be a good mother. But I did not, could not, listen.

Breastfeeding was not going well. In the hospital my baby would latch and unlatch, wailing furiously, an approach to eating we called “scream feeding.” I started using a nipple shield, to try to make latching easier. It helped a little, although he still fussed and screamed. One of the nurses kindly suggested we try supplementing with formula. I refused—I would just nurse for longer, try harder. The following day, after the pediatrician expressed a little concern about my son’s slow production of wet and dirty diapers, another nurse suggested, a little less kindly, that we really ought to give it a go. I acquiesced. My tiny baby, whose stomach was only supposed to be “the size of a marble”, sucked down an entire two-ounce bottle of ready-to-feed formula. Afterwards he was calm and sleepy, a different creature. A smiling lactation consultant came in with a $2000 breast pump, which I could rent from the hospital, and told me to try “triple-feeding”—where you nurse, then pump and then feed whatever you gathered plus formula, to help super charge your milk supply.

Overnight, I read a page of the English National Health Service’s website, which suggested that introducing a bottle and supplementing with formula in the first days after birth could lead a total failure to establish breastfeeding. I read pediatrician’s websites about how using devices like nipple shields could impair supply and impede the transfer of milk*. I spiraled. The next time I tried to feed my son I ditched the shield, but he fussed and fumbled and then screamed. He then seemed unwilling to nurse at all. I gave him more formula. All already seemed lost, then. All paths leading to failure. A Sophie’s choice: I could feed my child enough, and fail to establish breastfeeding, or I could starve him. I had read Emily Oster. I knew it was not a catastrophe if things did not work out and had recited to myself that “fed is best” in the months before birth. But that was not how it felt. It felt like I had approached the first hurdle of motherhood, just a couple of days in, and I had stumbled before it.

Then, when my son was five days old, my milk came in—the "before Christ, Anno Domini” of my own “breastfeeding journey”. It transpired there was plenty of it. Supplementing, nipple shields, bottles, pacifiers—none of it had impeded anything, although my son would now only nurse with a shield.

At first I was thrilled, relief washing over me. But the inconvenience of the shields quickly began to grate upon me. However many I bought there never seemed to be a clean one ready. Each time my son would cry out in hunger (which was, it seemed, all of the time) I would have to listen to him scream as I or my husband would flap around the house trying to find one, hurriedly washing it, and racing back to him. They are fiddly to use, trivial to lose and impossible to find. At night I resented having to turn on my bedside lamp, waking my son up fully, to retrieve the shield I had lost between the sheets. The “crunchy granola mom” on my shoulder whispered that direct latching was the best form of breastfeeding, anyway. Nipple shields are hardly nature’s way.

I started researching methods of weaning my son from them—and in doing so unwittingly took the first step towards making peace with the status quo. Nestled in a reddit thread about weaning tactics I stumbled upon a genius tip: keep it in your bra. KEEP IT IN YOUR BRA. Once you are done feeding just fold it up and tuck it in your bra! Then give it a wash the next time you pass by a sink. Immediately, I stopped losing them. There was always one ready. Feeding became a seamless experience, even in public. The effect was like releasing a pressure valve. All my pent up frustration fizzed away.

It was not until around ten weeks that I even bothered trying to nurse without them again. My baby seemed stronger, his latch deeper, his jaw bigger. I gave it a go and he seemed a little confused, then latched all the same. I used them on and off for a few days and then gave them up entirely.

Then, one morning, my baby would not feed at all. He had not eaten much overnight, so I was surprised—but assumed maybe he was just going through a phase. I tried again, half an hour later, and he still would not eat. Then again, half an hour after that, when he was starting to fuss and cry. I realised it could not be that he was not hungry. It was that he could not latch. I started searching for a shield, but we were at my in-law’s house and I had only brought a couple. One had accidentally gone through the washing machine and I had tossed it. My son started to scream.

I tore our room apart. I handed him, wailing, to my mother-in-law and started to get out my pump, hoping he could wait to take a bottle in a few minutes time. But by now he was frantic. It felt like we were right back in the hospital. I was incapable of feeding my howling son, only this time it really was my fault. My hubris, my desire to do things a certain way, my preferences. My baby had never cared how the food came, just that it was there. My husband clearly never cared, as he had told me kindly and often. The pediatrician in the hospital and once we were out—both just wanted the baby fed enough food, regardless of method. Only I cared. Only I cared. Only I cared.

Tangled up in the mess of pump parts and wires I found a loose shield. I ran back to my baby. Once it was in place he latched easily, immediately. After that I returned, chastened, to my old method.

Or, at least, I did for about another fortnight. Until my son—who was just learning to grab—seized the shield I was trying to affix in his tiny palm, threw it on the floor and started feeding anyway. And that was that. He has not needed to use one since. (This, it seems, is a common occurence around three or four months). I still keep them handy: there is one in the car, one in my handbag and a couple in a teal coloured cup on my nightstand. But I can look at them differently now. I am grateful for them, even fond of them. They are just a tool which helped me feed my baby. Nothing more or less. And how could I not be grateful for that.

***

When I started writing this essay, a few weeks ago, the lesson I was trying to build to was the message above—that of acceptance. (Feeding is so hard. However it shakes out, whatever tools you end up needing to use, I hope you come to be grateful for them, too. Think of the alternative!).

And then. And then, one evening, at four and a half months—when I had assumed all feeding issues were long in the past—my son was suddenly writhing around after his bedtime feed, unsatisfied, fussing and eventually screaming. I dove into my emergency freezer stash and gave him a few extra of ounces. He calmed. Then the same thing happened the next night. And the night after that. Once or twice, fine, maybe he was just a little extra hungry. But three is a trend and I began to panic. I could not keep on like this forever: my small freezer stash was already depleted. My husband tried to calm me, suggesting we just use the formula we had on hand to supplement the evening feed from now on. The idea was a fine one. (Adding a bit of formula to the nighttime feed is supposed to help a baby sleep longer, anyway). But I was overcome, again, with a fierce desire to do things a certain way.

It felt less existential than in the beginning, but was still frustrating and disorienting: I was reminded of how impossible it is to get a baby to do something it is resisting (like keep nursing) and how insidious it can be to lack faith in your milk supply. I thought, by now, I knew my baby and knew my body. I could tell when he fussing because he was tired, or bored. But here I was, again, worrying he must be hungry all of the time. I started feeding him constantly, at every whimper. It felt like I had been sucked back in time.

Frequent feeding combined with a little bit of pumping, a lactation latte powder** lent to me by a friend and consuming large volumes of water seem to have done the trick. Either it was just a growth spurt, which passed, or all the above helped boost my supply enough to meet my babies need again. But I have been newly humbled by the effort—and by how hard acceptance really is.

I thought feeding my baby would be hard and get easier. And it did for a long time. But nothing here—nothing about motherhood—is really linear. Perhaps that is the real lesson. The challenges might ebb and flow and change, but they will never vanish. Accepting that you have done enough, tried hard enough, is not a conclusion you can reach—certainly not at twelve weeks. It is a phase. Just like everything else.

*This is mostly nonsense, by the way. There is scant evidence the new silicone shields do anything of the sort—the old, hard plastic ones might have.

** It was this one in “cacao” and it is fantastic. I think a cup of this, a hour before the nighttime feed, really made the difference. I am still using it. I skipped it one night and he was grumpy again. It is also delicious (I make it with cow’s milk and a spoonful of honey).

P.S. Please forgive my skipping a week of this letter! A combination of the above feeding issues, some long sleep regression-y nights and being struck down by a stomach flu laid me rather low for the last couple of weeks. I, and baby, are doing very well now.