During research for my article on nipple shields for Clinical Lactation, I
could find no definitive recommendations for pumping when using a nipple
shield. There are no agreed upon protocols for this and we often use our
best judgement whether or not pumping needs to occur during shield use. I
always monitor the weight of the baby very closely and determine if the
mother's milk production is dropping while the shield is being used. If the
baby is late preterm, preterm, or there is a history or concern for reduced
milk production, then pumping is a reasonable recommendation.

Marsha Walker, RN, IBCLC
Weston, MA

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