Actually babies latch more deeply without a nipple shield than with one 
if they have sufficient muscle tone and tongue mobility to do so. This 
was confirmed on one of Donna Geddes' recent studies. The nipple tip 
winds up much closer to the junction of the hard and soft palate without 
the shield than with it in the same infants, in other words. The context 
of the study was to examine sucking pressure changes with a nipple 
shield in infants who exerted excessive vacuum during breastfeeding, 
both during sucking pauses and active sucking (who Donna calls "high 
baseline" babies.) Using the nipple shield decreased pressures in 10 
such infants (out of 10) but made the latch more shallow.

Catherine Watson Genna, BS, IBCLC NYC

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