Burden of proof here is to show why this tool SHOULD be used at this time, not why it shouldn't.  Adding a tool or intervention is the side of the equation which needs to be justified.  Start from the beginning: Mommy + Baby = Breastfeeding.  If No Breastfeeding is happening, what seems to be the biggest problem and what is the best way to fix it.  

When staff challenge something you are teaching, it is often because "they have always done it that way."  Help them to see it from the starting point of "breastfeeding works" and then extrapolate from there.  Validate their experience by recognizing that they may be right in some situations, but that doesn't make it best practice.  By the logic of "we've always done it that way," we could also still be doing a lot of things which aren't appropriate.  

Incidentally, in our facility we also have a strict policy of not encouraging or facilitating the use of nipple shields prior to Lactogenesis II, and if a mother brings her own and is using it, lactation staff is required to provide and document counseling which explains why it is contraindicated, the potential risks, and what precautions are recommended if she chooses to use the shield.  

Christine Staricka, IBCLC, CCE
Bakersfield, CA

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