Winnie, your statement about having everyone respond encouraged me to do so
and not put it off.  Jan, I used to always have moms pump after a feed for 5-10
min with double-elec, hosp-grade pump, then started advising on an individual
basis, until a mom who used the shield and had major oversupply began to cut
down on her pumping to the point where she missed a few days and her supply
plummeted, she panicked, gave ABM, and ended up weaning.  I had advised her to
pump 4-6 times/day and I remember how awful she felt and filled with self blame
for going the route she did.    So...I always have moms pump because I never
would have suspected that this mom would decrease supply as she was literally
gushing milk for weeks.

I had one mom who used shield very long term who stopped pumping after a few
weeks and went on to BF with shield without a problem.  I have moms using
shields have baby lick, nuzzle bare breast a few times a day but really like your
suggestion Winnie, of nipple stim/rolling before feed.  I think we don't know
which mom is more in need of the infant sucking to keep supply up but I do
think, even with the mom who's breastfeeding and pumping to increase supply, I've
seen supply increase better with baby at breast more often.  From my
experiences, the support and caring and "cheerleading-you can do it" is just as vital
in these ongoing problems of shield use or low supply.

Barbara Latterner, BSN, RN, IBCLC


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