Its been a very interesting discussion on reasons for and against nipple shields.  I stand with one foot on each side of the issue.  I don't advocate their use but I can understand their use, at times. One aspect of this whole discussion that seems missing though, is the mother's view of this equipment.

Since I don't dispense nipple shields,  my only experience with them has been with mothers who were desperate to get rid of them. So, of course, I understand that makes my viewpoint very different from those of you  who have the unenviable task of working the immediate postpartum period.  I truly don't know how much my viewpoint would change, if I worked within a hospital setting in the immediate postpartum period.  

The mothers I have worked with in regard to nipple shields were frustrated by them because of a variety of reasons.  The ever present concern(with any mother that is experiencing difficulties breastfeeding)was that of having to use a piece of equipment in the first place.  It was a symbol to them of an inadequacy of their body and their mothering ability,  "Why doesn't my baby like me, my breast, my nipple?"  Another problem for these mothers was(with prolonged use)how to go out and breastfeed in front of other people(even to a LLL meeting).  It seemed to me that these mothers felt like it was admitting publicly that they were inadequate.  Some of that desperation to get off the shield had to do with feeling trapped at home.  Another question that mothers had was that they didn't understand why they had been given a nipple shield.

One of the things that bothers me about nipple shields is that a plastic barrier is placed between mother and baby.  How much of the cueing to breastfeed has to do with smell and touch?  Seems like a minor thing to consider but I do believe that there is alot of minor, almost invisible to the eye actions that occurr during breastfeeding.  As a home visit LC, I have often run across the babies who for whatever reason have been refusing the breast since birth.  What is very fascinating to me is that after seeing enough of these situations, there were similarities of body movements of the mother and the baby.  I guess I'd call it the Breastfeeding Tango.  The mother moves her breast towards the infant, the infant backs away.  The mother then gives up and backs off and then the baby moves towards the breast.  The timing is all off!  The mother tries and gives up in reverse order to the infant. The key to stopping this back and forth motion is to make it as close to impossible for either one to back away and get them working in unison.  Of course, there are babies with sucking problems, but they are in the minority compared to these infants and mothers who seem so out of snyc with one another.  Valerie W. McClain, IBCLC  [log in to unmask]

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