Pam, I don't have a written policy where I work but I keep the shields in  my 
office.  The office is locked when I am not there.  
I do believe nipple shields have a place in the lactation field but I feel  
they are a tool that can be missed used and abused.  Therefore this is  what I 
tell my staff.
 
Moms should be at least 24 hours postpartum, and preferably closer to 48  
hours before a shield is introduced.  The rational behind this is that the  baby 
should have every opportunity to feel and mouth mom's bare skin.  This  
touching and licking has benefits to both the mother and baby.  
Next, colostrum is so thick and comes out in small amounts making it  
difficult to be extracted through a shield by the newborn.  The baby  would receive a 
larger dose of colostrum by licking what mom can hand express  than through a 
shield in these first 2 days.  Also, mom hand expressing  into a spoon and 
feeding her newborn would guarantee more intake than sucking on  a shield.
Shields given in the first couple of days make the nursing staff feel good  
but this is a false security because the likelihood of the baby actually taking 
 in any colostrum is very unlikely.
I do not have mothers sign any forms when giving them a shield.  I  introduce 
the tool, describing what it is, why I am recommending it, and how to  use 
it.  If the tool seems to be resolving the problem, than I discuss  weaning from 
the shield and this may take days, weeks or even sometimes  months.
I do not have moms pump when using a shield unless the situation calls for  
this measure.  If a shield is used correctly, babies can obtain full  feedings 
without compromising mom's supply.
Any mom requiring a shield should be followed by an LC, so that is why they  
are in my office to hopefully their use is under my direction.
Hope this helps.
Ann Perry, RN IBCLC
Boston, MA



************************************** See what's free at http://www.aol.com.

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]