Donna Lambert posted on a mother whose supply had dwindled to nothing by the
time her baby was weaned from shields, though "she attempted to increase
supply while using shield
but not even nursing every 15 minutes helped".
Donna also wrote: "Mom was given shield to use right after first attempted
latch on in hospital was not successful."

I operate on the premise that a shield is contraindicated in the first week
of life unless there is a clear problem such as low birth weight/prematurity
or difficulty latching which is attributable to some physical characteristic
of the baby.  I would even go so far as to say that giving a mother a shield
after the first latch attempt is not successful is evidence of inadequate
knowledge about breastfeeding, bordering on negligent malpractice.  Any unit
employing such people should be concerned.  I'd be astounded if that person
had given mother detailed instructions on the proper application of a
shield, or on how to establish and maintain her supply while using shields,
or how to wean from them (not to mention WHY to wean from them).  In my
experience women who contact me because of low supply, spending 'all their
time' feeding, or alternatively because of chronic engorgement, plugged
ducts and even full-blown mastitis, have often been shield users who fall
into the same category as Donna's case: the shield has been foisted on them
with no real indication and certainly with no information.  Many of them
don't even mention the shield until I ask specifically; it doesn't even
occur to them that the shield could be a problem.

And, the whole situation points up the problems arising when the person
dispensing the shield is not the person taking responsibility for following
the dyad until shields are no longer needed.  Maybe if they saw what a lot
of extra work and distress they are creating by this intervention when it is
not needed, they would stop giving them out this way.  As Barbara points
out, a baby who really can't latch on its own should alert us to giving
more, not less, help.  I would hesitate to make that judgment after a single
attempt, too.

Rachel Myr
Kristiansand, Norway

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