Expert: Sally Wendkos Olds - 1/23/2009

Question
Hi I'm Cody I have twin girls two months old.
I have a question for you about BFed and latching. One of my girls is
starting to refuse the breast. Since day one she has had some troubles
latching correctly. We use a nipple shield to help with my smaller nipples.
We have also had two bottles a day since say one (we needed her to gain
more weight) About a week or so ago I started having trouble getting her
to take the breast so I used a little chocolate to encourage her. It worked
for a few days but not anymore. She seems young to be self weening
right? Its really hard to have her screaming/crying at the breast while her
sister is trying to feed as well. Do I just call it quits with her? I do have a
pump but how would that work feed one while pumping? Where does my
LO that's not BFing go? I want to make it to 5/6 months but what can I
really do? Is there anything I can do to strengthen her latch? I know she's
getting milk but you can here where she's not getting full suction (she has
this problem with the bottles as well. I just need advice Thank you!

Answer
Dear Cody,

First, congratulations for giving your babies the best start in life by breastfeeding them!

You are right -- that your daughter with the latch-on problem (I'll call her Baby 1) is too young to be self-weaning. That doesn't happen until well into the second half of the first year, and often later. In fact, some babies never want to wean.

If you have not already spoken to a lactation consultant (LC), I urge you to do this right away. An LC can watch Baby 1 nurse and can probably see what the problem is. If your pediatrician has an LC on staff, or if the hospital where you delivered the twins has one, try them first. If not, ask a local La Leche League leader (to find an LLL leader, go to www.lalecheleague.org) to recommend someone, or go to www.ilca.org to recommend an LC near you. This is an investment that will pay for itself, in terms of better health for your baby and saving the money that formula would cost.

It's possible to pump from one breast while nursing from the other, but as you say you have another nursling to think about. Some women are able to pump soon after a feeding and get enough milk for the baby's next nursing.

The fact that Baby 1 is not getting full suction from bottles as well as the breast means that this is not just a breastfeeding problem. Have you spoken to your pediatrician about this? If not, call him/her and take the baby in. Have you had your doctor check to see if Baby 1 has a tight frenulum?

It's really hard to diagnose a problem like this
from a distance, but I want to urge you to get help right away. Most latch-on problems can be solved, and it's best to get to them early before the problem gets worse. You don't have to call it quits now.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with pediatrician Laura M. Marks, M.D.