Hello all,
  The discussion on nipple shields has been fascinating.  In my last two
days at work I passed out at least 5 nipple shields (I saw about 35
mothers). Some of the reasons I used them were for high palate,  flat
nipples-xn-stretchy areola, retracted tongue, and nipple preference. Since
we have a free lactation clinic, we request any mom who goes home with a
sheild return the following week for a visit.  At the visit we do a latch
evaluation with and without the shield, and weight check. We give Mom
instructions on how to wean baby off the shield if it is appropriate.
  e have not found that babies lose weight with the shield.  On the
contrary, we have found that mothers who took the baby off the shield once
they got home sometimes returned to the clinic with a baby who had lost
weight - what they thought was a good latch was not. Some mothers - such as
the one I gave a shield to on Wed, was off the shield by Thurs.  Her baby
had been given bottles since birth because he would not latch.  Her nipples
were pretty flat and areola non-stretchy. Since he was there all day Thurs,
I could evaluate his latch - he was doing well.
  Often I find that a baby with a high palate may need to use the shield a
lot longer.  We send MOB home with instructions for the nipple shield and an
appointment.

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