Melissa's information on Paula Meier using nipple shields with
prematures is correct.  I just heard her speak on this at the LLLI
conference.  She presented some materials not yet published and I
believe this use of nipple shields may be amoung them.

She said she resorted to using nipples shields when the premature
babies could not draw the mother's nipple out, due to their immature
suck.  She also said if they were able to get mom breastfeeding this
way in hospital she did not attempt to get them off the nipple shield
while still in hospital.  Some got off themselves at home, some did
not.

She had graphs of infant's suckling over the same time period graphs of
the same infant's breathing pattern.  It showed the alternation of
breathing and sucking that occur with bottles (in other words, apnea)
and the coordination of breathing and sucking that occurs with
breastfeeding (no apnea).  I asked her after the session (not on the
tape, sadly, because I think this is important information) if she had
any graphs of prematures using nipple shields to breastfeed and/or
using a feeding tube device to supplement at the breast.  She said she
did, and interestingly the nipple shield showed similar suck/breath
patterns as bottle feeding.  She also said the feeding tube device
showed similar suck/breath patterns as breastfeeding.

This tells me another reason why nipple shields should not be used
indiscriminatly (as if we didn't already have enough good reasons).  If
we believe bottle feeding to be a "risky" behavior, then breastfeeding
through a nipple shield may carry similar risks, at least as far a risk
of apnea goes.  I realize this is going beyound the research, but I
can't help it.  I'm just speculating but it makes sense to me.

My partner has used a few nipple shields for the non latching baby, at
times with a supplementing tubing device under - along with all
appropriate caveats.  I havn't, yet, but I stock them just in case I
run into a similar case, for last resort attempts.

It is late here, and I may be repeating someone else's story, but I've
heard of using nipple shields to slow the flow with over active
letdowns.  Probably "heard" it here, information overload at midnight,
EST.

Carla