I have to agree with Brenda, I would much rather send a mom home with
a baby at her breast with a shield than have her go home with a pump.
In many cases she will either become one of the growing legion of
pumping women or will quit entirely. Yes, nipple shield can be abused
just like any of our other tools but we just had a baby readmited for
dehydration because someone told her never to use the nipple shield.
This boy could not latch without it but know one told the mom what
else to do.

I have worked both as a private practice LC and a LC in the hospital.
The problems and stresses are very different. I had no idea. The
hospitals are the front lines. You see everything and everyone.
Private practice clients are generally motivated and willing to
hang-in their while we work to fix the problems. I am not saying that
one place is more difficult than the other, just very different.

We do about 1200 births a year and have a 97% breastfeeding rate. I
am the only LC. I have 1 or 2 visits to try and make sure that
everything is going well and the parents know the signs of when it is
not. (I tell moms with c-sections that the silver lining is still
being at the hospital when their milk starts gushing) If a nipple
shield will help this baby learn to breastfeed I use it. I always
tell the moms that it is like training wheels, a temporary help but
you don't want to use it any longer than you need to. (Thanks to
whomever used that analogy first.) Some times that means 1 day and
some times that means 8 months.

Yes the nurses do give out shields too often. No the follow-up is no
where near what it should be. But I have worked with many more moms
that have been helped by the new shields than have been harmed by
them. I would love to see someone do a good study on the newer
shields. Paula Mieir's study on shields and their use with premies
has made a big difference in the breastfeeding success rate in our
NICU.

Janet Hoover Malo, LM, IBCLC
Santa Cruz, CA

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