Hi Marie, I am also a lactation consultant in a hospital. I understand your dilemma. When I first started working in this setting, the nipple shields were locked up and it was a big production for a patient to get one. I was not a fan of this process. First of all, there are some very good nurses who know when and when not to use a shield. Secondly, if a nurse has not used a shield appropriately, then I educate her. Taking the access to the shields away seems punitive, and I'd rather educate. If a nurse uses a breastpump inappropriately for example, I educate her, I don't lock up the breastpumps. We are also fortunate to have our patients seen by an IBCLC each day. So if a shield is given out and not really needed, we can have mom discontinue using it, and show her another way. We make every effort to not over-use shields and to always use them appropriately and with specific follow up. We did a survey of about 25 moms that went home using shields and about 95% of them said the shield helped them and they probably would not be nursing if it hadn't been for the shield. Educating the staff about early and frequent access to the breast, as well as hand expression of colostrum to a spoon has helped eliminate early introduction of the shield as well. Hope this helps, and best wishes with your work. Mary PS: I was also at the Log Cabin conference. Great information! Thank you Catherine, Linda and Dr. V. ****** *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome