I agree wholeheartedly with Darlene Breed's comments on whield use
in the hospital.  Of course in the ideal situation we wouldn't be
using anything but mom's breast, but as those of us who work there
know, the ideal isn't always possible.  When a baby is nursing
through a shield, we need to use the same criteria as when it's
nursing directly.  Mom should not feel any pinching; baby should be
exhibiting deep jaw excursions; there needs to be audible swallowing
(although in the first days this can be subtle-the gutteral "eh"
"eh" soung is more common that real gulps and not as obvious without
really listening carefully-with the TV off for example).  If these
things are heard and there is milk (colostrum) in the shield
afterwards, there is transfer.  When we use a shield, in the
hospital we also have the mom pump for at least 10 minutes each
feeding she has needed the shield.  Anything she obtains is given to
the baby in whatever "device" seems to fit the individual mom/baby
situation the best.
Yes, shield use can save a breastfeeding relationship when a mom
might not be amenable to methods we as LC's may prefer.  Remember
Linds Smith's rule #2-"The mom is right".
Winnie Mading IBCLC

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