My suggestions are:
1. Always offer the breast without the shield first.  However, don't
let baby or mom get overly frustrated.
2. If baby won't latch without shield, try slipping it out (I didn't
care for the phrase "whip it away") after a few minutes.  By this
time, the initial hunger has eased and nipple tissue has been drawn
out (if that was a factor leading to shield use).
3. If removing doesn't work, finish feeding with shield.
4. Give as much skin-to-skin cuddling as possible between feeds.  I
have known a number of instances when "out of the blue" with no
identifiable reason, baby will squirm over and attach without the
shield.
5. If baby isn't making progress at getting off shield after a few
days (time depending on individual situations), I recommend she see
us as an outpatient so we can again work with her and baby
directly.  Sometimes, if a shield is helping in the first days, once
the milk volume "kicks in" and the initial fullness accompanying
that resolves, it is often easier to get baby to accept the breast
which is now giving "instant gratification".

Any time a mom has to work with a baby at breast rather than it just
happening with little effort, I recommend mom give baby at least as
much "cuddle time" as "work time" at breast.  This accomplishes 3
things: 1-baby doesn't begin to feel the breast isn't such a
pleasant place to be, 2-mom has relaxed, enjoyable time with baby in
contact with the breast, and 3-baby just might "get it" and latch
without much help.

In the15+ years I have worked with babies in the hospital, I have
known only a couple who have continued for months without ever
getting off the shield, but the vast majority do eventually.  I do
recommend keeping track of diaper output (not a detailed diary, just
check marks on a scrap of paper for each wet and each dirty over 24
hours until mom feels she can keep track without needing the actual
numbers) and a weight check before the typical 2 week checkup.

Winnie

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