>Like any tool, shields deserve to be used with caution and with follow-up.

Where I live, I absolutely agree.  But I had a surprising window on another
culture last year.

I was visiting a village in Alaska, accessible only by water (summer) or
plane.  It serves as a fly-in hospital center for surrounding villages that
are even smaller; most of the region's births take place there.

The nurses asked about nipple shields, and I started my standard line about
needing to have the assessment and follow-up done by an IBCLC (which they
have).  Well... it turns out they all hand shields out pretty casually and
frequently.  The mother tries to nurse, can't latch the baby right away,
uses a nipple shield a couple times, and by later that day has abandoned the
shield as being too much trouble.  It's a breastfeeding culture, you see.
The mother fully expects breastfeeding to work, it *does* work, and the
temporary use of this  crutch - which may not even be used "right" when they
use it - doesn't seem to interfere.

I told them what they're doing obviously works, and came away with a
wonderful reminder not to make suggestions in another culture without
knowing more about how that culture works.
--
Diane Wiessinger, MS, IBCLC  Ithaca, NY
www.wiessinger.baka.com

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