Right on Barbara-  I too feel like the queen of silicone at times.  I also
agree that just using a nipple shield without diagnosis is irresponsible.  A
complete history, physical assessment of the infant and child and then
deciding upon a plan.  If the plan includes the use of a nipple shield then
there needs to be informed consent and a time limited plan that the mother
understands.  When I prescribe a nipple shield the mother signs a consent
explaining why she is using the shield, it's potential side effects and the
need for carefull followup and frequent weights.  The mother always is
instructed to pump after feeds with a hospital grade pump.  Most mothers I see
will use the shield for 2 days-2 weeks.


Andrea Herron
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