The idea of a nipple shield policy is a great idea!
I wish this would happen here in my area. Nipple shields seem to be wipped
out immediately if a baby doesn't drink well from the breast (for whatever
reason). It really is appauling (sp?), it seems to me that the homehelp
nurses are using shields to help THEMSELVES to get through the week after a
birth (the time they spend looking after, usually, one mother and baby).  In
my region a mother gets home nursing help for 5-7 days after the birth,
there are then usually 3 or 4 days between the home-nurse help leaving the
mother and the district nurse coming in to do an intake and check things are
ok. Fine, if things are going well with the bfding, but what often happens
is that: 1. the mother is given a shield to 'help' with the bfding,  2. the
homehelp nurse never manages to help the mother latch properly with the
shield,  3. they don't pump milk after feeds to keep up production (why
bother? the baby is 'drinking' from the breast !)feed hind milk), 4. the
baby manages to come through the first week with just enough milk not to
lose too much weight, 5. the home help goes away, maybe writes in the notes
that mother/baby are feeding with a shield, but don't give reason, 6. mother
is left alone with no professional help for a few days, or doesn't seek it,
7. district nurse comes in and the breastfeeding has turned into a disaster
zone and there is no one who is really qualified(i.e. IBCLC qualified
district nurse) to pick up the pieces. The senario is usually that the
mother gets told not to use the nipple shield anymore (but with no follwoup
type of help with latch etc)  or eat chashew nuts and fat fish to 'improve'
her breast milk!  The idea that a baby has to get to the 'new improved' milk
to receive its 'benefits' just doesn't dawn on those supposed to be helping
the mother/baby.

I know, I'm having a stab at our 'health' system, but I got the same old
story from a mother this morning asking for help and its hard not to get
extremely synical about it. Maybe, instead of getting synical, its time to
suggest that these mothers need specialised follow-up help from the same
system that is failing them. A nipple shield policy would go a long way, but
only if there were experienced LC's or nurses to implement them.
Unfortunately, here in my region there aren't.

Oh yes, the caschew nuts and fatty fish are the in thing at the moment here!

Sara Bernard
(staying off the caschew nuts and fatty fish even if my bmilk ever needs
'improving'!)

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