Hi Melinda,
The thing that will drive her milk supply is effective milk removal at
every feeding. The best way, in my opinion, to check this baby is through
weight checks. I might do weekly for a couple weeks. If there is a big
concern, a pre and post feed weight could be done, but this does not seem
necessary for this dyad.
There really is no compelling reason to wean from the shield *if feedings
go much better with the shield* and *milk transfer is better with the
shield.* And, of course, that is why we use a shield, for better latch and
milk transfer. I do not use them for sore nipples, in my practice. Mothers
very often lose the shield and have to go out and buy more or stash several
around the house, so that is one reason moms want to get weaned, and for
being able to latch baby right on, rather than trying to place the shield
with a squirming, hungry baby.
Many mothers are able to wean the shield over days or weeks, but some use
it their whole lactation, and that is ok, if all else is going well.
The shield instructions and our standard of care call for post-feed milk
expression, and I think that is very useful in the early days and weeks
even, as shield use is generally a marker for difficult establishment of
bf. However, once bf is well established, supply is good, and milk transfer
and wt gains are good, I don't believe moms have to continue this post-feed
expressing, unless they want to have a back-up of extra milk, or have an
*insurance* of a little overproduction.
Hope this is helpful to you,
Laurie
Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA
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