I agree with other posters who have said the shield may be more a marker
than the sole cause of this baby's problems.
Barbara Wilson-Clay points out that in order for shields to be helpful they
should be correctly used for the correct reasons (I am paraphrasing wildly
and I know it, sorry Barbara!).  We don't know why shields were introduced
in this case but my hunch is that it was inappropriate, because the sad
truth is that it very often is.  At the risk of making you all groan I will
reiterate the line from 'Enabling women to breastfeed' about shields: if you
are not going to follow the dyad until shields are no longer needed, or
until they are no longer a concern, you shouldn't introduce them.  It is
this lackadaisical attitude to quasi-solutions of BF problems that gives
shields a bad name, I think.  Most people handing out shields are not Paula
Meier or her colleagues, and more's the pity.

I would be very concerned about a baby who was not up to birth weight at 3
weeks, since when BF is going well, most babies I see are at or above
birthweight by about 5 days, and many are there by day 4.  The slow
regainers are a big concern, and it is not until they pass their birth
weights that many of them seem to get the energy they need to feed
effectively.  So I would second the rest of what Barbara says, about getting
milk into this baby now, and fix the BF later.  It is not reasonable to
expect a baby who is struggling to get back up to birth weight, to do the
work of bringing a lagging supply up to speed at the same time.  The mother
will have to do it for the baby until the baby is vigorous enough to latch
well and nurse for a full feed.

Finger feeding could be a good way to get the baby fattened up AND help it
develop more effective suckling technique for use at the breast.  Jack
Newman's handout on it, at www.bflrc.com , is excellent for how to do it.  I
have ventured to try it several times recently, for indications as listed in
Jack's handout, and it is very, very different from both bottles and
shields, in ways it is hard to explain.

Rachel Myr
who never has liked shields much anyway, in Kristiansand, Norway

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