I have been reading alot of posts, of late, regarding the use and efficacy of
nipple shields. True, they are often overused and used incorrectly. I just
want to share a few experiences that I have had with their use. I am a
lactation consultant in a 65 bed NICU. We try to initiate skin to skin asap,
but unfortunately, we have holding policies related to weight. It is an
antiquated theory, but that's what we are dealing with. Also, in our unit,
babies are always given their first po feedings via volufeeder and nipple
(even if it is EBM). Anyway, often, when we see a mom for an initial BF
consult, her baby is being discharged very soon and has had little experience
with skin to skin. As most of you who work in NICU's know, babies leave the
hospital at a corrected gestational age that is still considered premature,
i.e. 34-37 weeks. Moms have been diligently pumping for weeks, sometimes,
even months. When the baby can finally go to the breast for a nutritive
feeding, often they have such difficulty latching that momand/or baby get very
frustrated. When this occurs, I have no qualms about demonstrating the proper
use of the nipple shield, and trying it to see what happens. Moms are elated
when their babies actually suck with LJM/AS noted and they actually see milk
in the tip of the shield! This also provides the skin to skin that might not
have occured too often during the hospital stay...The progress can be
validated by AC/PC weights to see what the baby actually is getting. If
nothing else, it gives the moms the boost they need to continue this process
when baby is discharged. We follow these mothers via phone contact and
outpatient referrals intensely to monitor the progress of the baby.
It's such an everyday dilemma to work in an NICU and want to much for these
mothers and babies to succeed at breastfeeding. In whatever ways we can
contribute to make this a successful experience for them, I'm all for it.
If any other NICU LC's have any thoughts on the nipple shields or any other
gadgets they find helpful, please e-mail me privately...
Warm regards from Atlanta!
Elyse Blair, RN, BSN, IBCLC
|
