Debbie,

In the past nipple shields were made of thick - and then later thinner -
rubber, not made out of silicone like they are today.  Then it was suggested
that mothers cut a little bit away from the tip of the nipple shield every
day, so eventually the nipple would protrude through the hole, and the baby
would transition to the breast.  

Even though all materials now say NOT to cut away the tip because the
material of the silicone nipple shields today would become sharp where the
cut was made, I am sure there are old publications still floating around out
there that have the information about cutting away the tip.

I have a funny story about this.  In my early days as an LC I went on a home
visit to a mother whose baby was on the older rubber nipple shield, and
mother wanted to transition the baby off.  She had been told by someone else
to cut away a little of the shield every day and she informed me that she
had been doing that.  

She was concerned that she would lose the nipple shield in the night or that
the baby would choke on it.  I assured her that the nipple shield, even
though cut, was still big enough and wouldn't be a choking hazard.  

When I got to the house her mother and sister greeted me at the door.  They
thanked me for coming and also mentioned how worried they were that the baby
would choke on the cut nipple shield.  I thought this was very odd.  Then
the mother brought out the shield.  She had not understood the directions.
She had cut away from the rim!  All that was left was what looked like a
thimble!  No wonder they all were worried that the baby would choke.  She
actually had been placing that little thimble-shaped,
what-was-left-of-the-nipple-shield piece on her nipple and nursing with that
on.  I had to turn around and stifle a laugh!  I told her that by observing
how much she had trimmed the nipple shield down I was sure that she wouldn't
need it any more!  I didn't want to hurt her feelings or embarrass her.  I
have told this story many times since then to other LCs. One time, though, a
fellow LC told me I probably should have told her the truth - what if she
shared her "successful" way of transitioning her baby off the rubber nipple
shield with other mothers.

LLLI carries a tear-off sheet entitled NIPPLE SHIELDS that mentions slightly
about the rubber nipple shields of the past, and then gives management info
for today's silicone ones.  If anyone would like a sample of it, email me
privately with your name and mailing address, and I will be happy to send
one out to you.  These are copyrighted and can't be copied.  They are
available in the LLL catalog in pads of 50, and also at bulk rates, so they
are very reasonably priced.

Katy Lebbing, BS, IBCLC, RLC
La Leche League Leader
Manager, Center for Breastfeeding Information
Education and Member Services
La Leche League International
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Date:    Fri, 27 May 2005 20:57:18 EDT
From:    "Debbie Albert, Ph.D., IBCLC" <[log in to unmask]>
Subject: Re: Cutting the nipple portion of the nipple shield

Can anyone tell me where this practice originated?  I am currently  working 
with a mother who set her up with nipple shields, and then started  
progressively cutting them down.  Now of course, the mother has quite a
wonderful crack 
on her left nipple.  I will check the archives for  previous discussion, but

could someone enlighten me on the "purpose" of  this.  The doula told this 
mother that the baby will get more milk this  way.  I don't buy it, and all
I can 
think of is --OUCH.  I would  never cut a shield except to create a nose
area 
on those 20 mm  shields.  When will those poor 20 mm women deserve a contact

shield?
 
Debbie Albert, RN, Ph.D., LMHC, IBCLC, RLC
Tampa Lactation Counseling
Tampa, FL   

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