I'm concerned about the ready support of nipple shields.  Nipple shields
are a tool, like any other.  And yes they do have their indications, but
like any other tool they have their down-side - a possible reduction in
milk transfer and milk supply over time being just one - there's also
imprinting to the shield, reinforcement of poor latch and increased risk of
infection.
Paula Meier has researched and published on the use of nipple shields in a
cohort of preterm, low tone infants which demonstrated that this group of
babies could benefit by increased milk intake from their use.  This
research cannot be extrapolated to a full term, normal tone baby.  In her
paper she has hypothesised reasons why it may be successful in this group -
none of these reasons applying to full term, normal tone babies.  This may
be good research, but would carry a lot more weight if it were replicated,
and I hope some large NICUs are doing just that.
I've previously reported in Lactnet on a study of thin silastic nipple
shield use over a 12-month period at a major Sydney hospital where
excellent lactation consultancy and follow-up occurred for every case.  Of
the infants who were fed with a shield (assume excellent teaching), 47%
either didn't gain weight or lost weight between hospital discharge and
follow-up at 11 days. Of the 53% who gained weight the gain was 25g to
300+g.  So even some in the weight gain group were marginal - though some
thrived.  (For more details of this study search archives using my name
(not email, I've changed it) and 'nipple shields' going back to the
beginning of 2000).
What's my point?  Even in the very few cases where a nipple shield is
indicated, and is prescribed by an expert lactation consultant who gives
excellent teaching, only SOME babies will do well.  Treat with caution.

Denise

Denise Fisher
mailto:[log in to unmask]
http://www.health-e-learning.com

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