At the risk of sounding (again) like the Queen of Silicone, may I point out
several things about the use of tools?  First, you have to understand how
and why a tool works, and under what circumstances it might be the RIGHT
tool for the job.  Second, you have to exercise reasonable diligence during
its use to monitor if and how it is working.  Thirdly, it is necessary to
monitor outcomes to see if your results justify continuing to fool with it.
Selection of ANY tool should be based upon a specific rationale arising from
the situation of the individual dyad being assessed.

The fact that nipple shields are randomly tossed at mothers with non-nursing
babies is a condemnation not of the tool, but of the poor training and
supervision of the population serving breastfeeding women.  It testifies to
the absolute poverty of our investment in really having breastfeeding
specialists whose province is the dyad presenting with non-robust, abnormal
feeding behavior.  It argues eloquently for more theoretical education of
lactation consultants, RNs and whoever else is involved.  That tools are
carelessly selected and outcomes go unmonitored is intolerable scientific
and intellectual laziness with profound ethical implications.  Physical
Therapists are FEEDING specialists.  We are supposed to be BREASTfeeding
specialists.  If we present ourselves to consumers as such, we have a moral
responsibility to try to understand what we are doing.  That includes
EDUCATED use of therapeutic tools.

Barbara Wilson-Clay BSEd., IBCLC
Private Practice, Austin Texas
Visit the "LactNews-On-Line" Web Page
http://www.jump.net/~bwc/lactnews.html