>Not one of my favorite subjects, but I will comment on the facts.  An article
>in Early Human Development, 4:357, 1980 done by Woolridge, Baum, and Drewett
>showed that with the traditional (Mexican Hat) that milk transfer was reduced
>by 58% and that with the thin Latex nipple shield (many on the market), milk
>supply was reduced by 22%.  Studies have shown that with the thin, silicone
>nipple shield, milk supply decreases  18%.

It is precisely for these reasons that we are trying to get babies off
the wretched things! :-( The plan is to get babies directly on the
breast as soon as possible, but if a baby has been nursing say 3 months
with shields, you cannot take them away suddenly without serious
problems (if anyone has any ideas, we'd be glad to hear them). Even so,
I would not imagine they would be needed for more than a few weeks -
often, by the time we see a mother, her milk supply is dwindling fast
and the baby is in grave danger of being weaned. If our techniques don't
work quickly, they don't work at all :-( Unfortunately, nipple shields
are being prescribed very frequently in this area by ignorant health
professionals - midwives, Health Visitors and doctors, for the
"treatment" of sore nipples (positioning, latch-on and correcting
problems like tongue-tie seem to be largely ignored as possible
solutions). We never get to see most of the women who end up weaning
because of them - just the odd "stubborn" one who has reached the point
of desparation. Most women just put the baby onto the bottle as the baby
starts losing weight due to the low milk supply. They no doubt tell
everyone their milk mysteriously "just went away" :-(

>I have had people ask if there
>are recommendations to cut back the nipple shield for weaning the baby off
>the shield.  Medela suggests never to cut back the nipple shield because
>there have been instances with various nipple shields that babies have gotten
>cuts in their mouths.

That is the problem with silicone nipple shields, and is precisely what
we have found happening. Many mothers try to cut them back, but often
with negative results (such as babies with cut lips). Latex shields,
OTOH, do not cut the baby's mouth when cut back.

>  I personally found, way back a few years, that cutting
>them back never helped anyway because the baby would just scream and cry when
>it was low enough and want the shield back again.

That has not been my friend's experience - she has found cutting shields
down to be a very effective method, but *only* with the old latex
shields.
--
Anna (mummy to Emma, born 17th Jan 1995 and Alice, born 11th Sept 1996)
Email: [log in to unmask]  Web Page: http://www.ratbag.demon.co.uk/anna