Hi Everyone,

I had an incredibly unusual situation last week, that I am still sort of
fuming over,
although Caoch Smith would say to be "open to change". We use nipple shields
in our hospital based practice more than I would like, but can say we have
had
great sucess with them and provide close followup with anyone being
discharged
with them as per a certain protocol we've developed.

Last week, unbeknownst to me a patient was given an orthodontic nipple to
try as a
shield by a nursing instructor (at that time) who works as a midwife
elswhere, and says
they use them "all the time" with great results. I was not able to make
contact that day with
this brand new person to our hospital (it was her first clinical day as an
ADN instructor!
It is probably just as well as I was fairly ballistic after the subsequent
contact I had with the
patient involved. She was determined to use it since it worked so much
better than the shield.
What to do about it - will be taken care of - I shall "seek first to
understand" now that my
temper has cooled, and plan to approach her this week.

My question is " is any professional IBCLC or even non IBCLC's recommending
or using these
EVER? Certainly , I know of no evidence-based research that states they are
suitable for use,
only the research that exists on shields. Since the patient was determined
to use this despite
my reservations, everything was clearly documented on the patient record.
She did have a pump in style at home and agreed to pump hindmilk.
Unfortunately, my
relationship to the patient was completely compromised  because of this
instructors actions and
the patient refused LC followup, except with her MD, who is not particulary
supportive of breastfeeding mothers.

How about it  anyone...care to comment?

P.S  And by the way  in keeping with the current thread, it was yet another
mother who had flat
nipples that might have been helped with shells prenatally, skipped prenatal
breastfeeding
class, who ended up a failed forceps and subsequent vacuum extraction and a
baby with a terribly disorganized suck! Some things, just don't seem to
change much!





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