Dear Friends:
    I've been thinking about nipple shields a lot while I have been shoveling
snow, since there have been so many posts about them!
    I don't think I have given out 10 nipple shields in the past 20 years.
Sometimes mothers come to me after having been given one, most often for
premature infants.  Nipple shields are rarely in my practice; the most common things
I recommend in care plans  are skin-to-skin care, cue-based feeds, pumping,
safe co-sleeping, nursing in side-lying position, asymmetrical latch, supporting
the weight of the breast, pulling baby's butt close (so the head can drop
back) and self-attachment. I have only recommended a supplemental nursing system
maybe 5 times in my career, and several were for adopting mothers. I refer to
an infant feeding specialist, because of the babies I see or may use CST in
care, but that is individually determined.
    If a mom is pumping and bottle-feeding, I suggest bottle feeding in a
breastfeeding style, which includes stimulating rooting and for baby to latch
onto the teat. I also recommend pumping for 140-150 minutes total per day, which
is a number that shows up in different research studies at the time babies
spend breastfeeding in 24 hours. (Kung women bf 60 x/day for 2.5 minutes/ feed
gives about the same number as women in DeCarvalho's study about bf and jaundice
and weight gain.)
    Barbara and others have stressed the importance of individualized care.
No one needs or wants to be treated like a recipe to be followed; and less so
when there are two individuals to work with (mother and baby). I concur.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CIMI, CCE, craniosacral therapy
Adjunct faculty, Union Institute and University, Maternal and Child Health:
Lactation Consulting
Supporting the WHO Code and the Mother Friendly Childbirth Initiative

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html