Lisa asked about nipple shields for inverted nipples.
I'm no fan of nipple shields, but many women with inverted nipples have
gone on to breastfeed for many many months using a nipple shield for every
feed.  It's lovely to hear that this woman and her sisters were all
prepared to pump to provide breastmilk for their babies - it wasn't the
easy option they elected to do.

I can see no point whatsoever in introducing a nipple shield before the
milk comes in.  The milk transfer is always significantly reduced by a
shield, and the very small volumes we know baby will be getting before then
will mostly just coat the shield.  Besides this is the time to get the baby
to 'imprint' onto the mothers nipples (or lack thereof) - sometimes, if
they have never known anything different, they will actually achieve a fair
latch (and with the information Jean Cotterman has been giving us) in a
week or so with increased stretchability and compressibility they may
continue without further problems. I recall one of my mentors telling me
that you don't need nipples to breastfeed. Granted, nipples do usually make
latch heaps easier.  But if they were never given that chance because of
early shield use...
Sounds like Lisa did give the baby all those chances though with no success.

Rule #1 of course has to be remembered all the time.
I do actually think that sending a mother home to pump and bottle feed is
'being at wits end' - and would have tried a shield before advising that.
JMHO.

If you get the chance to see this mother again I would advise attempting a
breastfeed with a nipple shield. The baby has been used to a bottle nipple
now and may take it quite happily. You just need to make sure her latch
causes the bottom gums to be over the lactiferous sinuses and do all the
usual things to make sure intake is adequate.  Then in a week or so of
reasonable feeding with the shield (or maybe longer depending on the
voraciousness of the baby) I'd start giving the 'weaning off the shield'
suggestions.

Denise



****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
****************************************************

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