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In a message dated 5/12/2010 5:07:53 P.M. Eastern Daylight Time,
[log in to unmask] writes:
<<<<I will be publishing a few articles on nipple shields in Breastfeeding
Medicine in the next few months>>>>
will very much look forward to that.................
<<<<So any use of the shield must be accompanied by pumping afterwards.>>>>
I agree absolutely, ....pumping after each use at least till abundant
supply and wt gain, then may gradually slack of pumping while watching supply,
....................
For hospital use there should be a policy, procedures, mandatory education
of staff, and documentation of staff learning appropriate use and follow-up
planning.
<<<<Which lead to the question of why use a shield when
nursing,pumping,bottle feeding is 3 steps, and pumping and bottle
feeding is 2 steps, while baby practices infant-led latch.>>>>
Very Good question
For some moms the extra step of shield feeding is indeed too much.
For some moms the extra step of practicing infant-led latch with truly
uncooperative nipples/areola is too frustrating until that anatomy can be
improved.
For some moms, some reasons for shield use may include:
-getting some milk from the breast via a shield is better than no milk from
the breast without a shield
-feeding with shield provides some nipple stim and milk flow
-shield feeding may help truly flat, retracting, dimpled, inverted etc type
nipples to become more graspable, as might the pumping afterwards
-some moms feel better about having the baby somewhat *closer* to
breastfeeding than all bottle feeding
-babies get accustomed to breastfeeding positions
Some hospitals may have mom & LC sign a mutually agreed upon plan-of-care
document for shield use.
This extra documentation can highlight the importance of **very judicious
and discerning use** and Prudently Planned follow-up.
Debbie Tobin
RN BSN IBCLC
Fairfax County, Virginia suburbs outside the Washington DC beltway
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