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Teaching Hugo to Nurse

Four weeks into my baby’s life, I was still crying every day.

When I gave birth, I had been an international board-certified lactation consultant for almost 11 years. Before that, I was a birth doula and breastfeeding educator. It’s no exaggeration to say I’ve probably worked with 10,000+ new families. People would say “Oh you’re an LC— when you have a baby, you won’t have any problems!” I knew that wasn’t true, especially after seeing some of my LC colleagues really struggle with their babies. BUT… I also did not expect to be hit with as many different challenges as we were hit with.

A newborn baby asleep at the breast

I knew breastfeeding could be hard—very hard—but it was still emotionally brutal to be the one going through the difficulties. We struggled with feeding from the moment Hugo was born—starting with difficulty latching and sucking at all, then confronting low supply, ties, pain, plugged ducts. It felt endless.

The one benefit being an LC gave me was a deep well of determination and an endless list of resources and things to try next. I also had the incredible support of Jen Deshaies, IBCLC. Over the first month we went through shields, SNS, paced bottle feeding, chiropractic care, tie release, aftercare, osteopath visits, rhythmic movement exercises, pumping, supplements and meds to get my supply up.

A newborn baby lying on a cushioned pad receiving chiropractic care

Dealing with low supply was emotionally very hard, but what I feared most of all was never establishing a nursing relationship. I wanted to avoid the work and challenges of exclusive pumping, and I also treasured the moments he did latch and comfort nurse to sleep.

Like so many of the patients who have come to me for help, I simply wanted to be able to feed my baby.

After 4 weeks of grueling work I was finally seeing a decent increase in supply, but still had a baby who was struggling to transfer. I was freely using my own feeding scale and found he was generally transferring 2-8 mL per nursing session. The best we did was a long, long session with an SNS where he transferred 18 mL from me, in addition to the full feed from the SNS. Generally, he took a few sucks and just fell asleep.

I knew to turn to Ellen from my experience of working with her for many years as a professional colleague. In the past, when I hit a wall with helping a patient or wanted another perspective on a tough situation, I went straight to Ellen every time. When I moved away from North Carolina and she was no longer local to me, I still used her as a professional sounding board and even had her support a couple of my patients via Zoom when I was stumped.

Was there any hope for my own nursing journey? When I hit my own wall, of course I knew I had to call Ellen.

I told her I was trying to apply a couple things I’d learned from her, but I was struggling and nothing seemed to make a difference. Should I try a shield again? Keep going with the SNS?

Ellen was emphatic: No. Don’t keep throwing things at the problem hoping they might help somehow. She proposed a call where we would work on his feeding together. Jen joined the call too, so she could see what we were working on.

We all got on Zoom and I got Hugo latched on and feeding...well, at least trying to feed. Ellen coached me through adjusting his positioning and working on his suck… (including stopping the breast compressions, which I did reflexively in an effort to keep him interested).

When he seemed done, I took him off and put him on the scale to see that he’d transferred… 24 mL!

What might seem like a small amount, maybe a quarter of the feed he needed, was monumental for us. No SNS, no endless feeding time. I was beyond thrilled and finally hopeful.

Ellen also watched my wife give him a bottle and gave her specific instructions for suck training during bottle feeding...and off we went! Within a few days he was up to transferring 40-60 mL — I was so excited that I texted Ellen and Jen photos of the number displayed on the scale.

Progress from there was slow but steady— a week later we were able to start dropping supplemental bottles after a couple feeds per day, and two weeks after that we had essentially eliminated supplemental bottles and he was actually gaining percentiles on the growth chart.

We had some ups and downs from there, but he continued to be able to get everything he needed from breastfeeding. He actually dropped bottles completely around the 3 month mark, nursing exclusively until he added solids around 6 months and then figured out how to drink from a straw cup around 9 months. His weight gain at every pediatrician appointment was textbook.

Now at 20 months, Hugo loves nursing and asks for "nana" when he's tired or upset. I love it too—being able to connect, comfort, and snuggle with my busy toddler through nursing every day.

While direct breastfeeding isn't important to every parent, it was and is to me—and I am profoundly grateful for the support from Ellen and Jen that I received to make it happen.

And I love that seeing Ellen's work inspired Jen to learn these techniques herself and even join in the work of helping teach other IBCLCs about them! I want every single family to achieve their feeding goals the way I was privileged to, and we can do that by helping add Ellen's tools and techniques to IBCLC toolboxes everywhere.

Respectfully submitted by:

Rebecca Costello, IBCLC

Ithaca, NY


Register here for the Advanced Clinical Skills for Rethinking Lactation Support virtual workshop, being held on January 25th, 2023!

Participants will have access to the recording of the event until February 10th if they aren't able to attend live or would like to review at their own pace.


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