In a message dated 2/21/0 11:18:21 AM, Heather writes:

<< Nipple shields may well be a useful tool in the right hands in some tricky
situations, but without good follow-up they are risky.>>

yes, that is why good follow-up should come *after* good/approrpriate initial
instructions and management plan to prevent low supply and inadequate weight
gain from occuring at all.

<<... often see mothers at 7 or 10 or even more days, using a shield, and
often having had a fright because they have discovered their baby is not
gaining weight at all, and may even be continuing to lose weight..... *most*
women who use a nipple shield do experience ill effects. ....midwives either
rustle them up from some hidden
corner or get the fathers to buy them and bring them in.  .... mother then
went on to have *serious* problems with supply>>

those moms did not get/hear/follow the good/approrpriate/comprehensive
initial instructions and management plan, and this is why some experienced
lcs hide nipple shields behind locked doors and develop/follow a hospital
policy on shield use/management.

Debbie

Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway

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