I'm sort of behind on things so I don't know if anyone else has
mentioned this.

To me one of the ___theoretical___ concerns with the prolonged use of
nipple shields would have to do with prolactin receptor development.
This would seem to be most important in the primip who has not
established breastfeeding capacity, and less of an issue with the multip
who has had successful long term breastfeeding relationship(s) in the
past, as they seem to have lots of prolactin receptors and are able to
maintain long-term breastmilk supply.

But IF the nipple shield resulted in less nipple stimulation and thus
less prolactin release there would be a lower blood level of prolactin
to supply stimulation of the receptors.  It seems as if there could be
supply problem long-term, later down the road.  Having not observed
enough mothers with long-term shield usage, I don't have any clinical
experience to report.

How about it--those of you who have seen long-term shield usage--does it
influence milk supply at say four months?  Does anyone have the data to
help us out here?  Would be one of those studies that would be hard to
continue if you saw negative results in the first few participants!  But
it sure would be reassuring if you didn't <VBG>

Melinda Hoskins, MS, RN