I have a private practice and rarely see babies before 3 days postpartum.  I
land on the individual assessment side; close phone followup, ideally more
than one visit, and close watch on weights, diaper counts, observation of
supply.  I use the technique "don't need to pump if the feed was good" and
then teach what good is (some babies don't show a good feed for a long time;
these moms need to pump frequently).  Among interventions, nipple shield use
combined with pumping seems to be relatively easy for many mothers to
follow. I find they usually  want to pump, by the way, since around here,
pumping is the norm.
My biggest problem with shields is getting a good, deep latch.

Kate Sharp, IBCLC
LC in NYC
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