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Dear all,
I am sorry if I offended anyone about my comment regarding slapping on
nipple shields. Our hospital is baby friendly and unfortunately there
has been poor control over who provides nipple shields, despite many
attempts by the LCs to limit their use. Women have received nipple
shields within virtually 3 hours after delivery by non-LC nurses. I am
sure our hospital is not the only place where this is happening.
There is no arguing the research...all 3 studies looking at milk
transfer in healthy, term newborns who nurse well demonstrate a decrease
in milk transfer with the shield. A baby who nurses poorly without a
shield may transfer more milk with a shield, but that does not mean that
the shield will not impact milk supply. If that same baby were a
champion nurser, milk transfer would probably be greater without the
shield, according to current research findings.
Granted, the current evidence all the way around is of poor quality. We
need to remember that using a nipple shield is an intervention, and an
intervention should be cleared medically as safe before we use it often
or routinely. Since we don't know the impact of nipple shields long term
on a mother's milk supply and duration of breastfeeding, I recommend
proceeding very cautiously with its use.
I am singing to the choir here, I realize, and I believe that any LCs
diligent enough to keep up with Lactnet are likely to be careful and
conscientious providers. The problem is that others watch what you
do/how you practice, and may decide to use nipple shields in
inappropriate situations.
Anne
Anne Eglash MD
Clinical Associate Professor
Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)
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