Dear Dr. Eglash:
I loved your post.
I teach in a University program that leads students along Pathway 3 to
become IBCLCs. The students have a mentor for their clinical hours. The
students sometimes see dreadful practice, and, want to copy what their
mentors are doing. particularly with nipple shield on Day 1 (!) in healthy
dyads. Some of the students are clearly resistant to any research or
clinical opinions that I give.
I would love to share your post with my colleagues and with the students!
warmly,
Date: Wed, 20 Feb 2013 18:37:12 -0600
From: Anne Eglash <[log in to unmask]>
Subject: nipple shield use in hospitals
I very much disagree with nipple shield use in those first few days
postpartum. We have NO good evidence that a silicone nipple shield will do
anything to improve the baby's chances of latching without the shield, nor
do we have evidence that the baby will transfer milk well, and that mom
will maintain her prolactin level and milk supply using the shield without
additional pumping. In fact, the few studies done with very few patients
suggest that nipple shields could have a negative effect on lactation. I
published a review of nipple shield use in Breastfeeding Medicine 2011, I
am happy to share this with any one interested.
The nipple shield is wonderful for nurses because they can give it to the
mom, baby will latch, and the nurse does not have to hang around to help
the baby latch any further...her job is done. However, I have seen many
moms in my lactation clinic who have a low milk supply in relation to using
the shield, and many curse the fact that someone told them to use it in the
hospital. If mom is given a shield, she will need to do 3 things, that is
nurse, pump, then supplement. I prefer, especially early on postpartum that
moms do lots of skin to skin and infant-led latch and give the baby a
chance!!!! IF the baby won't latch by 24 hours, start supplementing with
finger feeding or bottle, and pump regularly. Those are 2 tasks, not 3.
And, continue to give the baby more chances!!!
In addition, from my experience infant led latch does not work as well
after nipple shield use because the baby looks for a silicone nipple when
the baby travels down to the breast. I think using nipple shields early on
is like imprinting baby ducklings on decoys. Infant latch is very deeply
ingrained in all mammals, humans as well as puppies and kittens. We need to
really work on stimulating that infant reflex, not impatiently quashing it.
Anne
Anne Eglash MD, FABM, IBCLC
Clinical Professor
Dept of Family Medicine
Medical Director UW Lactation Clinic
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)
608-550-3054 (pager
--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy*
www.breastfeedingalwaysbest.com
https://www.facebook.com/nikkileehealth
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
