I totally agree with both Anne and Kathy. One mom recently was given a shield on the delivery table!!!!!! When I was a hospital LC, way back in the olden days, I kept nipple shields in my locker -locked! I also find that giving these shields out so quickly hides TT issues. Pat in SNJ
On 02/11/15, Anne Eglash wrote:
I strongly agree with Kathy Lilleskov. I don't know how often those who are
giving out nipple shields in the hospital are seeing these dyads over the
next several weeks/ months, but in my lactation clinic I have seen
devastating losses of milk supply due to lack of milk transfer and
insufficient breast emptying with nipple shield use early on. In addition,
many women suffer from nipple trauma with the shield, due to an infant's
tendency to nurse superficially on the shield. I think that giving them out
in the hospital postpartum is too early. As a provider, I have never, in 25
years, given a nipple shield postpartum to a breastfeeding mom. If the baby
won't latch, I strongly advise skin-skin and infant led latch, along with
pumping and supplementing. Eventually, if everyone believes in the baby and
understand the proper cues, the baby will latch.
I see a great deal of risk with nipple shield use early on. The risks do not
outweigh the advantages from my experience.
Anne
Anne Eglash MD, IBCLC, FABM
Clinical Professor, Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
Medical Director of UW Health Lactation Services
Co- Medical Director, Mothers Milk Bank of the Western Great Lakes
President of The Milk Mob, A Gang of Breastfeeding and Human Lactation
Educators
www.themilkmob.org
Breastfeeding is Nature's Health Plan
Date: Wed, 11 Feb 2015 12:52:29 -0500
From: Kathy Lilleskov <[log in to unmask]>
Subject: Re: Nipple Shield Guidelines
As an OB nurse I was the one working with nipple shields in the hospital and
it was not until I became a private practice LC with a scale, that I
realized how many babies get absolutely nothing through the shield. They
can't get milk out. This can be catastrophic for milk supply if it not
addressed. If i were writing hospital policy, I would advise pumping after
every single feeding and offer any expressed milk back to baby until you can
demonstrate that the baby is able to transfer milk. Ideally that would be
demonstrated via a before and after feeding weight check. If this is not
possible then once the milk is in and she wants to start weaning from
pumping and offering expressed milk, the baby should be weighed at least
evey 5 days or so, until weight gain with shield alone can be validated. I
would also make sure that they understand that a baby who falls asleep very
quickly at the breast and then cries when removed from the breast, may be
showing signs of isufficient transfer. And count those urinations.
Kathy Lilleskov RN IBCLC
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