Hi, Ellen, et. al About nipple shields and premies. Ellen, we never use a nipple shield if the baby is doing well at the breast. But in a baby with suck problems, or where there is an anatomic misfit, nipple shields work wonderfully well. There was a whole issue of JHL dedicated to the issue of nipple shields a few years ago and it was only after reading it that I (and our OT )got interested in using them to improve poor suck and latch in preterm babies. We had so many babies come back to follow-up clinic STILL not knowing how to breast OR bottle feed. It is amazing to watch those little immature guys latch on to a shield which fills with milk, there is no intermittent "Niagara Falls" letdown for the baby to control, and they start to swallow. The latch deepens and the suck improves as their little eyes pop open in surprise. "Hey, I did it!" And for a mom who has been struggling trying to get her little one to "do it" for days or weeks, to actually have the baby nursing at the breast is a major success. They cry! Admittedly, we do put babies to breast much earlier than many institutions. Incidentally, our breastfeeding initiation rate in our NICU is about 95%. Our current bf duration rate three months AFTER DISCHARGE, is 73%. (Defined as babies receiving all or most of feedings with breast milk either by breast or artificial means, including SNS) Have a good day, everybody. I have 100 people coming to my house tonight. Gotta go! Deanne, RN IBCLC NICU *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html