Jan asked: > When you determine > that a mom/baby couplet needs to use a nipple shield, do you have her do any > insurance pumping? If so, when, how often, and for how long? And why? > I've had mothers use quite a number of nipple shields over the past several years. Especially since Paula Meier's research showed that preemies tired less and sustained being at the breast longer with their use. We have babies from 36 weeks gestational age and up. Uses: 1. Mothers who have traumatized nipples due to babies' disorganized or dysfunctional sucks 2. Mothers who are at risk for quitting breastfeeding when they've been using an incorrect position/latch and have damage to their nipples. When we get the latch corrected many can nurse, but some still find the pain too intense and dread feeding their babies. 3. Babies, who no matter how much we work on latch (using concepts from Best Feeding and articles on the off-center latch), cannot manage to get latched on, e.g. onto a breast with flat or inverted nipples Sometimes the shield is used only on one side. Often for one to three days; other times for up to five weeks. Usually for a week or so. I've only had one baby who never got off the shield and who at 11 months of age would bring the shield to his Mom when he wanted to nurse! We do not have the mothers pump. Only twice in several years have I had a mother who has needed to pump when their babies seemed to not be gaining that half ounce to ounce per day. Some come back for weight checks with me when weight gain has been a concern. Otherwise we go by diaper output and nursing frequency and well baby visits to the doc (2 days post discharge and two weeks). I follow-up all mothers who are using nipple shields. Mardrey Swenson IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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