In a message dated 2/6/2004 3:14:31 PM Central Standard Time,
[log in to unmask] writes:
Nipple shields.  Many in the study group used a nipple shield after milk had
come in ... and for the babies who needed them, it often took until 42 weeks
gestational age until it could be eliminated.
This hasn't always been my experience.....taking until 42 weeks gestation to
eliminate the nipple shield.  I'm wondering why the difference?  For instance,
today I called back a mom I'd consulted with on Monday.  Her baby was born at
36 weeks and she was unable to latch baby onto breast.  At the consult, I
assessed the latch, and when I found baby was unable to sustain the latch and
transfer adequately (4 cc's), I used a nipple shield.  Baby was then able to
transfer 46 cc's.

My callback today to mom revealed baby's taking feedings without use of the
shield now.  Weight check at doc's office yesterday revealed baby's gaining
adequate weight, whereas he'd been gaining slow.  I've had some babies require
the shield post-40 weeks gestation, but often times they only require the shield
for a few days.  It seems apparent to me that these babies needed the
assistance to sustain the latch initially as a result of lack of tone, and that they
developed muscle tone with the suckling pattern exhibited at the breast.  This
improved muscle tone then results in babies not continuing to need to use the
shield.  And, it seems to make a difference if moms are taught to maintain
kangarooing and attempting to latch to the bare breast briefly without the
shield at feedings.

Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
St. Charles, IL

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