On Mon, 28 Nov 2005, LuAnn Smith wrote:
".... Avent nipple shield .... They are very
small, .... and only is about an 1 to 1 and 1/4 inch wide. I would be very
afraid of aspiration, as they are silicone soft and too smal IMHO."
Hi LuAann:
Last time I looked (Brisbane, Australia), this brand had *two* sizes, but both had the disadvantages of being very firm, not soft the way you describe. The pharmacies are full of products of this brand and at one stage it was difficult to find other brands, though I have no trouble getting other brands now.
The small version of the above brand was *too narrow* for some nipples. I saw a Mum some years ago who was using one and it was too tight and visibly contricting her nipple (ouch!). I usually find the larger model of the same brand too long as the tip is harder and less flexible than most and I've noticed babies find it more difficult to get their mouths over it when latching. So the mother moves the baby to assist and the latch goes haywire.
On the relatively infrequent occasions when my clinical judgment is to use a nipple shield, there are better, softer ones available. I keep several, in two brands, one with two sizes, so that - on the sporadic occasions when needed - I can usually find an appropriate "fit". The thin, soft ones seem to help the mother feel she really *is* breastfeeding - less obvious. Another advantage of the softer ones is that (if appropriate) the mother can warm them and slightly stretch them at the juncture of the shaft and the flange, allowing more of her breast to be drawn in. I think this has been discussed on Lactnet before, and some Lactnetters weren't happy about the idea of stretching them (though ever so slightly) as they saw this as a modification.
Mothers often think that there is just one size, or that all nipple shields are the same. This perception isn't helped when they buy them over-the-counter and don't have advice on the fit, nor on whether the device is appropriate for their situation.
Actually, it is amazing what is still on pharmacy shelves, and it looks to be new stock. One still sometimes sees the old-style bulb-type breast relievers, relatively little changed since a British patent granted to Jennings and Lavater back in the 19th century, in April 1864. [Watts S. Mother's little helpers or the history of the breast pump. Food for Tot, 2002;14(1):2-8.] A few months ago I counted the products marketed as colic drops and on the shelves in just one local pharmacy, and there were 7 brands.
Cheers
Virginia
in Brisbane (during the stormy season - sunny now, storm forecast for later)
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