I haven't read all of the posts on the thread about this, but I wanted to
share some experience with using a shield and the SNS (or Lact-Aid)
together.  This was one of my steps in getting my adopted daughter Julia,
who was nearly a year old, to the breast, 12 years ago.  What I used was an
Ameda Egnell latex shield, but I think it would work the same with a
silicone shield.

I taped the tube to my breast, before putting on the shield.  I used a long
length of tape and taped it right down my areola, to the base of my nipple,
so it would stay where it needed to be and the end of it could not get
turned around when the shield was on.  I then put the shield on very
carefully (like someone else said, almost turn it inside out, to get a snug
fit).  With that, it didn't matter if the tube was protruding through a hole
in the shield or not, because it couldn't get far away from a hole.  I also
taped the shield in a couple places.  With a baby who is willing to take the
breast, that is probably not necessary.  With Julia, I had to try to avoid
anything that would frustrate her at all, like having to re-position the
shield during a feeding would have.

I really like the idea of putting the tube onto the shield, too.  With
Julia, I needed to be able to take the shield off and still have the tube in
place on my breast, so I could move when she was still sucking and almost
asleep, and try to get her to latch right onto the breast, with the tube
still there (since my milk production was pretty limited).  If being able to
move the shield during a nursing session was not needed, mounting the tube
onto the shield would probably be easier, and also would not require
subjecting the mother's skin (especially on the areola) to the tape.

Does anyone even market latex nipple shields anymore?  I was amazed that
they could ever have been used to help sore nipples!   I started out with no
soreness, and not overly sensitive, since my 2 year old still nursed for a
few minutes, a couple time a day.  It didn't take long nursing with the
shield before I had VERY sore nipples!  In fact, that led me to hurry faster
to move onto the next step in Julia's metamorphosis from bottle to breast,
just to get rid of the darned thing!  It also meant that I had quite a bit
of pain when she started nursing.  She had 16 teeth, which were sharper than
any of the other three I nursed with teeth, and she had a habit of biting.
I really had to grit my teeth alot, knowing that if I reacted, she would be
upset and might start rejecting the breast again, after all we had been
throught to get her there.  My elation over having her finally accepting my
breast helped alot, though!  Julia had come to me as a 9 pound,
developmentally delayed, traumatized, six month old, who was fed primarily
through a gastrostomy,  took no comfort in sucking, and would not even let
me hold her, except sitting on my hip, facing away from me.  To have her
happily nursing was well worth the toenail curling moments!

Aloha,
Darillyn

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