Hi, ladies. This is my first post after several months of lurking. I can't 
tell you how much I've learned from this list.
 Anyway, I'm a breastfeeding support volunteer with a local non-profit in 
Austin, Texas. I do follow-up calls with breastfeeding moms at 1 week, 3 
weeks, and 3 months. I've been seeing what I think is a disturbing trend 
lately, and I'd love to get your feedback on it.
 It seems like a lot of the moms I work with are being given nipple shields 
at the hospital as a quick fix to deal with latch problems, rather than 
receiving any real help with getting their babies to latch. Often, they are 
given next to no instruction on how to use the shield, and even less 
instruction on how to transition away from it. This week alone, I talked 
with several new moms in tears at 1 week PP, who were absolute wrecks 
because the baby wouldn't latch without the shield, barely latched with it, 
they couldn't get the shield to stay in place as they nursed, and they were 
getting deeper and deeper into the downward spiral of pumping and 
bottlefeeding EBM instead of nursing at the breast. Often, these babies are 
showing clear signs of nipple confusion already, and the moms are 
supplementing with formula because the baby seems like he's not getting much 
due to the ongoing latch problems. In all of these cases, the nipple shield 
has clearly done more harm than good and threatened the sustainability of 
the nursing relationship, and in all of these cases, there have been easy 
and clear alternative ways of dealing with the underlying problem that 
should have been tried before resorting to the nipple shield. And none of 
these moms were getting ongoing lactation care with regard to the nipple 
shield use, or had any idea how to get away from them. I know that nipple 
shields have their place, but I am getting so frustrated with the cavalier 
overuse of them that I'm encountering. 
 I'd love to hear your thoughts on this.
 -Koren Martin, breastfeeding support volunteer
Austin, TX

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