I use nipple shields frequently as well at our hospital, but I only have a select few nurses who have access to them. If I left them out for everyone to use, I am certain, absolutely certain, that 2/3 of our patients would have them needlessly. Our nurses often look for the quickest solution when they are busy. As long as the baby latches, they are ok with that. I strongly feel that nipple shields must be monitored closely, and that if a baby is sent home with one and is not getting good milk transfer, the hospital could be held liable. 

And back to size...I have rarely - maybe 1 or 2 moms in 10 years - had a baby transfer milk adequately with a 24 mm nipple shield. It is extremely difficult for a newborn to latch to the nipple AND areola with these larger shields. In my experience, this size shield leads to problems not only with poor weight gain, but also milk supply deficit. And because of this experience, and the many train wrecks I've had to fix, I do not understand why Medela continues to put them out on the shelves of Target. It seems to be a huge liability. 

Cathy, I am going to check into that nipple shield from Germany!

Brenda Phipps, BS, IBCLC

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