Ruth:
I've been an LC for 10 years and have always studiously avoided using nipple
shields due to all the concerns we know.  However, for various reasons (very
damaged nipples, nipple confusion) in the last 6 months I've had to use one.  In
both cases moms were planning to discontinue attempting to breastfeed.  The
mothers were very thoroughly informed of the risks and the need to maintain a
close watch on wet diapers, stools and weight gain.  Babies have thrived, moms
have continued breastfeeding.  One mom has been able to maintain milk supply
even when continuing to use the M----a Breast Shield for over 6 months.  In both
cases, moms had no milk supply problems to begin with, and it never developed.
So now I use them as a last resort - but not so reluctantly.
Jeanette Panchula, BSW, RN, IBCLC  -  Trying to make things Baby Friendly in
Puerto Rico.