Barbara, thank you for your wise comments re: Nipple shield use.  They
are a tool that can be very useful under the correct circumstances, and
when they are NOT used in place of skilled assessment and help.
Unfortunately, a local doctor's office here orders them by the 100s, and
they pass them out in place of skilled help.  This is an affront to good
practice, and is not a substitute for knowledgeable assessment and
intervention. Unfortunately, this seems to be the norm rather than the
exception.

Kathleen



The technology of the new, thin silicone shields is different from the
old Mexican hats and antique designs, however it is important to be
aware of the persistence of shields of old design and of the size issue.
All shield intitiation should be done after in-person assessment, and
shield use should be monitored to assure the baby is gaining
appropriately.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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