I reviewed all of the available literature on nipple shield use and
published this literature review in Breastfeeding Medicine in 2010.
If you'd like this article, please email me privately. I don't think the
attachment will work on digest mode.
Anyway, there is very little literature on the safety of nipple shields,
in terms of preserving milk supply, maintaining the prolactin level, and
the risk of diverting a baby to prefer a firm, artificial nipple.
It should be proven that nipple shields are safe before they are widely
used, especially in the first week or so postpartum, before milk supply
is established. This has not been done.
The notion that we should prove that they are unsafe before rejecting
them, at any time during the lactation process, is unethical science. We
have to assume that nipple shields may disrupt the normal physiology of
nipple stimulation=>elevated prolaction, and the infant's ability to
fully empty the breast, before embracing their use. This has not been done.
Bottom line from my view-they should never be used until milk supply is
well established. Even then, mothers need to understand that there is
not good proof (other than a few relatively poor studies with few
patients over a short time) that they can maintain their milk supplies
using a nipple shield, without some extra nipple stim and breast drainage.
Anne
Anne Eglash MD, FABM, IBCLC
Clinical 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)
608-550-3054 (pager)
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