I see lots of mothers who received a nipple shield at the hospital, or their friend suggested it to them.  Often I can get them latched without it.  Or we find a different size works better.  I rarely introduce a shield to the mix.

My hot-button issue with shields is that the mother does not understand she STILL needs to get a good latch.  I teach good shield latch in terms of better milk transfer and as part of the path back to direct breastfeeding.  I often show the good and bad latch pictures from the Breastfeeding Atlas.

I tend to see:
- Mom leaning over the baby, shoving the shield into the mouth before getting a wide gape,
- Shield bobbing in/out of the mouth,
- Shallow latch,
- Sloppy latch where baby and shield are coming away from mom so milk is running out under the shield.

Even when we've gotten acceptable transfer and latch in my office, I think many moms revert to old habits when they're on their own.  I love it when the scale shows better transfer without the shield than with it because it is so motivating for the mom.  And I love it even more when I can point out how much better the baby reacts to direct breastfeeding. (Not every situation is fairy tale perfect, of course.)

I had one mom tell me the hospital suggested she use the shield while pumping.  I hope she misunderstood.

Susan Nelson MS IBCLC
Austin Texas USA

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