I have to second Barbara Wilson-Clay's comments about some peoples'
aversion to using a nipple shield when a baby can't/won't breastfeed
directly.

A bit of background may also help.  #1 The reason an entire issue (when I
was Editor-in-Chief) appeared in JHL was because lactation consultants
ASKED for one!  They were the ones who submitted the papers, which were
duly reviewed and either rejected, or accepted for publication. I
anticipated receiving some that showed negative impact of nipple shields,
but none with this orientation was ever submitted!

My own experience (over time) has shown that when nipple shields are used
for what they were intended (to enable the baby to breastfeed), they work
well.  They do require follow-up, which I also provide and they should not
be given (like candy) to every new mother.

But, when a baby cannot/will not feed at breast and you wish to preserve
the breastfeeding relationship, a nipple shield may be just what is needed
to help the mother and baby make the transition from some other kind of
feeding (much more expensive, time consuming, etc.) than using the shield
for a period.

We have all heard of horror stories that used to abound about how this
little device was MISused. As a result-as pointed out by Molly Pessl in her
guest editorial-people in the know moved away from nipple shields and their
use declined dramatically.

As skilled observers began to dominate in the field, they discovered that
the nipple shield (I am talking exclusively of the very thin ones now
dominant in the market) did seem to work without the negative outcomes seen
previously.  Unfortuantely, not everyone got the message.  And, as a
result, people who are still reading the old studies/recommendations are
not yet up to speed.

It is time to stop trying to shoot the messengers.  It is overtime that
people read the newer information and consider it carefully.  That is how a
profession and its professionals grow.  While change may be painful-we all
know professionals who still practice as they were taught in
nursing/medical school; are we so very different?-it is necessary, nay
essential if our profession is to be taken seriously.

If you question what others have done, fine.  But in questioning, use your
own abilities, skills, as well as your eyes and ears when with new mothers
and babies.  They continue to be my finest teachers, even as I compare what
they tell me with what the professional literature suggests.  SUch a
combination of teachers has required that my clinical approaches change and
IMPROVE over the years. To do otherwise is to provide less than optimal
assistance.


     mailto:[log in to unmask]

"We are all faced with a series of great opportunities brilliantly
disguised as impossible situations."
Kathleen G. Auerbach,PhD, IBCLC (Ferndale, WA USA) [log in to unmask]
WEB PAGE: http://www.telcomplus.com/~kga/lactation.html
LACTNET archives http://library.ummed.edu/lsv/archives/lactnet.html