Mothers stay for inpatient is between 24-48 hours. This is a very short/limited time. I personally do not recommend nipple shield use during this time period at all. When we place a pump to mothers breast prior to transitional milk the result we see if few drops of any. The same is resulted when using a nipple shield during the time period of colostrum. A few drops may come off mothers nipple and fall to the bottom of the shield, infant gets tons of spit inside the shield but there is hardly any milk transfer.
Using a nipple shield during colostrum phase raises many concerns for:
1) Milk transfer
2) Lack of stimulation of mother breast
3) Baby becomes 'addicted' so early to the texture of the shield instead of the breast
I work for a facility when i have the ability to not only see inpatients but outpatients as well. I will inform you that a large percentage of babies i see who are dx with FTT mothers are using nipple shield and have been since birth.
I think it is important to allow baby time to 'get used to the texture of the breast'. Until transitional milk comes in I teach mother how to hand express and spoon feed. Each family is unique and for some they want to the use of a pump either manual or electric but once they do it and see they didn't get anything out versus when they hand express and actually see something on that spoon that they can dribble into their babies mouth.
So if a mother is using a nipple shield initially then yes they should be doing something to remove milk to give it to the baby.
Jessica Callahan RN, IBCLC
NC, USA
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