Dear all,
I am sorry if I offended anyone about my comment regarding slapping on 
nipple shields. Our hospital is baby friendly and unfortunately there 
has been poor control over who provides nipple shields, despite many 
attempts by the LCs to limit their use. Women have received nipple 
shields within virtually 3 hours after delivery by non-LC nurses. I am 
sure our hospital is not the only place where this is happening.
There is no arguing the research...all 3 studies looking at milk 
transfer in healthy, term newborns who nurse well demonstrate a decrease 
in milk transfer with the shield. A baby who nurses poorly without a 
shield may transfer more milk with a shield, but that does not mean that 
the shield will not impact milk supply. If that same baby were a 
champion nurser, milk transfer would probably be greater without the 
shield, according to current research findings.
Granted, the current evidence all the way around is of poor quality. We 
need to remember that using a nipple shield is an intervention, and an 
intervention should be cleared medically as safe before we use it often 
or routinely. Since we don't know the impact of nipple shields long term 
on a mother's milk supply and duration of breastfeeding, I recommend 
proceeding very cautiously with its use.
I am singing to the choir here, I realize, and I believe that any LCs 
diligent enough to keep up with Lactnet are likely to be careful and 
conscientious providers. The problem is that others watch what you 
do/how you practice, and may decide to use nipple shields in 
inappropriate situations.
Anne

Anne Eglash MD
Clinical Associate Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)

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