Hi, Mary,
Nipple shield use has been discussed extensively in the past, so there is
good info in the archives, but I think that things are always changing.
Because so much about American birth is abnormal and assaults normal
breastfeeding behavior, I think that nipple shields can save the
breastfeeding relationship. Also, the latest research suggests that they are
not as detrimental as once believed (Wilson-Clay, 1996; Meier, multiple
cites, esp 2000; Powers, 2004; Chertok, 2005). Based on Dr. Chertok's
research and presentation at ILCA, I was able to get our hospital to drop
the n/s use consent form. It presented yet another barrier to bf--what
mothers really need is a consent form for formula use.
There is a good discussion about appropriate nipple shield use in The
Breastfeeding Atlas. When used appropriately for a specific purpose, with
adequate explanation and buy-in by the mother, they can help, and d/c use
doesn't seem to be a big deal. The situations we find they are helpful for
include preterm babies (have done our own informal ac/pc checks and had the
same exp as Dr. Meier); the truly flat/inverted nipple that doesn't resolve
with reverse pressure softening; the drugged baby that can't maintain a
latch for love nor money; the baby who's been given bottles for several
feeds (a whole 'nother problem); oral anomalies such as tongue-tie that
won't be fixed in our hospital. I always have moms do RPS first, btw, even
with n/s use. Now that is a miracle tool, thank you, Jean Cotterman!
Warmly,
Anna Swisher, MBA, IBCLC
Abundant Blessings
Austin, TX
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