I'm enjoying our professional interchange on the topic of nipple shields.
Mary Kay I received your post twice so at least some of them are getting
through.  A couple of things I'd like to comment on ... I don't think
anyone has said nipple shields are "evil".  In our discussions we have all
commented that they do have uses.  BUT they also have side effects.  I'm
very surprised to hear that the Breastfeeding Answer Book has stated that
nipple shields don't decrease milk supply - I wonder where that research is
because I haven't seen it ... only varying reports that it does.  Even in
Paula's study she didn't look at whether they decreased supply or not, she
was only looking at milk transfer in her select population (her mothers
also pumping and having over-supply before they even attempted breastfeeding).
It does sound like experiential evidence for many of us confirms that
nipple shields DO have a use, BUT the experience of many is also that they
can cause more problems than they solve, particularly in inexperienced
hands.  The research that I quoted also demonstrated that even in
experienced hands nipple shields don't always solve the problem that it was
hoped they would and can put infant's at risk.
I'm not dead-set against shields.  I have used them in selected cases with
success, but my criteria for use is very tight.  I also make a lot of money
out of other people (not LCs) starting mothers on shields as they come to
me to pick up the pieces.
I liked the idea someone suggested (?Rachel) that whoever prescribes the
shield must remain responsible for that dyad until the intervention they
implemented is no longer needed.

Just rambling on a bit longer while I've got the soapbox... I do like the
idea that non-lactation experts be very aware of the problems of nipple
shields and that they not prescribe them because of this.  However, when a
woman has been prescribed one by a Lactation Consultant, such as occurred
with Carol's case, that should a midwife/nurse/doctor/whoever then tell the
mother not to use it that that person deserves a letter of objection from
the LC stating something along the lines of who the expert in infant
feeding is and that it would be against your professional ethics to tell a
mother that the treatment they had instituted was wrong and that you expect
the same courtesy.  OK - I can be a bit blunt at times - maybe Naomi B-Y or
Barbara W-C could draft a letter for us.

Denise

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

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