The research that showed that milk transfer was decreased with silicone
nipple shields was done with the mother using the nipple shield while
breastPUMPING rather than breastfeeding.
No science is perfect, and as we go on we learn! We didn't know then
what we know about suck mechanics. And there's a ton we don't know yet.
In my own practice, I individualize pumping recommendations. If the baby
is transferring milk well, I don't recommend extra pumping (had several
cases of miserable oversupply that taught me this was not a benign
intervention for all women). If baby is not transferring well, we
certainly pump and supplement. And each mom goes home with a reminder to
watch her baby and shift strategies if something changes.
Catherine Watson Genna, BS, IBCLC NYC
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