In a message dated 4/18/01 1:14:03 PM Central Daylight Time,
[log in to unmask] writes:


> data support that if the correct
> size of nipple shield is employed, and if the baby is correctly latched,
> unstable feeders can actually access significantly MORE milk with than
> without a nipple shield (Meier, et al JHL 2000).  Nipple shields have been
> demonstrated to be effective bridging devices for the breast-refusing infant
> who has had many bottles, and are effective clinical tools in the
> maintenance of breastfeeding when flat or inverted nipples are an
> issue(Wilson-Clay, JHL 1996).  Data do not support significant inhibition of
> prolactin stim. with the newer silicone shields (Woolridge, Early Hum Dev,
> 1980).  A risk of their use is they can contribute to increased mastitis.

This raises a few questions in my mind......

If baby were latched correctly without the shield, there might not be a
problem to begin with.....hence it seems strange to add "correctly latched"
with the shield doesn't it?

Does getting "more" milk have anything to do with Mom "believing" that the
nipple shield is the savior and relaxing, thus allowing optimal letdown?

Speaking of "breast- refusing infant who has had many bottles".....isn't the
problem two fold.....NICU's that use artificial nipples instead of the many
other options......and standard nipple confusion which can be broken quickly
if baby is at a healthy enough weight to endure the initial first day that is
toughest if going cold turkey back to breast?

Wouldn't the use of nipple shields in the instance of flat or inverted
nipples LESSEN the strength of the suction to pull the nipple out?
(p.s.....personal experience of both on this issue)

Couldn't the risk of contributing to increased mastitis also be linked to
inadequate draining of the breast, even tho Woolridge disagrees?

Just some thoughts.  As much as I like to lay credence in the laps of those
having done studies......there are times when what you see in personal
experience over years makes you wonder how they managed to arrive with the
conclusions they did.

I do agree that the creation of many problems with the use of nipple shields
has to do with inadequate diagnosis and support to begin with....but isn't
that the creation of many or most of the problems we deal with?

Cheryl Taylor White

             ***********************************************
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