Hello Lactnetters,
Please help me understand breast shells.  I am the LC at a rest home for mothers - and their babies -after birth. The women who stay there love breast shells and wear them all the time.  I have heard so many reasons for them being worn.  The two most comman reasons are - to protect sore nipples and to prevent engorgement.  I have tried to explain to the women the problems caused by wearing shells with no air holes and have begun to provide better ones (they are going to use shells no matter what).  I provide nipple protecters - and ofcourse proper intervention to those with sore nipples - as opposed to nipple formers to avoid problems caused by the constant pressure on the areola.  This is what I need clarified.  I remember learning that constant use of shields can cause a decreased milk supply but I can't find that written any where.  What is the connection between shells and engorgement?  Why does the pressure of the shell on the areola cause leaking but pressing on our nipples/areolas with our hands stops an untimely let down.  Someone today said that wearing shells caused her headaches because the constant leaking led to constant milk production, which overloaded her pituitary.  What do you think?  Now the night nurse has insisted that I provide a supply of shells for all the women who need them at night to collect all their leaking milk - most of them don't nurse at night but leave ebm for the nurses to give.  I suggested that she supply them with pads but she says that pads are not enough.  Until now I have never had to deal with questions about shell use and suddenly I'm bombarded. I'm so glad to have someone(s) to turn to.  I would really appreciate your collective wisdom on this one.
Thanks, 
Chayn Fogelman, Israel

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