At my hospital (and the other 2 in our system) the bedside nurse does NOT have access to just whipping out a nipple shield and using it.  They are in the Lactation Consultants office.  We use them only when needed.  With strict instructions and follow up.  Pumping is a must when they are used.  We have several Lactation Counselors who work as bediside nurses (and cover sometimes on my days off), 2 IBCLCs that are bedside NICU nurses, myself the fulltime Lactation Consultant, and another educator who is an IBCLC who covers from time to time.  They all know the shields are not a first line to help.  

Having a nipple shield available for typical bedside nurses to use is a BAD idea.  There is so much they need to understand.  And the first thing is that MOST MOMS have perfectly normal nipples.  Aren't we all kind of tired of hearing the mom has flat (and even inverted) nipples, we walk in the room and we think...what the heck was that nurse thinking??  This mom has perfectly fine nipples!  These poor moms, they must be so confused.  

Pamela A. Hendrix, BA, RNIV, IBCLC, RLC
S. Florida hospital based 




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