ahhhh.. a pet peeve of mine!

There are many nurses in our area hospitals that use nipple shields in the first 12-24 hours and then say baby has latched.. in one case it was a personal friend of mine whose baby was "lazy", given a nipple shield and shown how to hand express and use a hand pump, then told she didn't need to pump for at least 3 weeks while breastfeeding was established.. so, then I find out a few days later that mom is giving baby a supplemental bottle as he is refusing to latch with the nipple shield and without the nipple shield.. and he is not peeing or pooping.. so smart mother fed the baby, poor mom - crying to me that I'll think she is a bad mother... and I am thinking "Nope! lazy nurses"... I was able to go over and see what was going on.. no one showed this mom how to latch the baby with or without the nipple shield. No one went over the reasons for using it.. (no good reason - mom had perfectly normal nipples to begin with.. I know.. I've seen her in a t-shirt on a cold day on more than one occasion!) and then not one of these nurses were there to help her at home when she ran into trouble. I know the head IBCLC at the facility and shared my thoughts about this.. I really think that, for these practices to change, the nurses who pull out nipple shields as a "cure all" for lack of expertise and time spent need to find out what happens when these mothers go home.

My friend is still not breastfeeding. She is pumping and feeding ebm, but she is not breastfeeding. She was given pump flanges that were too small when shown the hand pump which caused a further problem with debridement of the skin off her nipples resulting in terrible swelling and pain. She was not shown how to latch her baby at all and no information regarding what to do if her baby wouldn't latch on the shield... 

One week later I got a LLL call from a mom in almost an identical situation.. for every mother who calls me, there are at least that many that don't - probably way more..

IMHO nipple shields should be locked away and only accessed by trained (read "IBCLC") staff. Period. They seem rather benign... what harm can a thin silicone shield do, really?! But, though they have an important place in certain situations, they are not a "catch all" tool to speed up breastfeeding learning and can be insidious and, as we all see, dangerous in the hands of inexperienced persons. Furthermore, all nurses who hand them out should be responsible for doing all follow up with that mother/infant dyad (I know.. not feasible...) at the very least they should all have to listen to tapes, repeatedly, of the calls we get from these moms... baby crying, mom crying, father crying... should be mandatory training!!! These are NOT benign objects.. 

Another deterrent may be fiscal... when a mother runs into problems, such as my friend did, her pump rental should be gratis... free... at the expense of the facility... . and if she has to supplement with other milks because of it... that too should not be at the parent's expense.. same with the APNO, the Mother's Milk Special Blend, the future dental work... you get my drift... 
get them in the pocket book.. guaranteed these facilities will be locking away the nipple shields lickety split!

I, too, needed to vent, I see! 

Celina D, LLLL, IBCLC 

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome