After having so many trainings in which Barbara Wilson Clay has been present, I'm a firm believer in the 16 or 20mm nipple shields. I find the 16mm works best for the baby, but not always best for the mom's nipple size. Having said that, I am appalled at the continued marketing practices by Medela, at least in our neck of the woods in Nothern AZ. Their shields are sold at the local Target store, and only in one size last time I checked - the 24mm, which states it is "regular" in size. Now how many women believe that they are "regular", especially when Medela, a nationally known company, puts them on the shelf with no other sizes? 

I contacted the Medela rep in my state, as well as the marketing department, to express my concerns. I was told they would think about changing the packaging to make it clearer to women that this product should be used under the guidance of an LC. This still does not fix anything, because women will continue to buy the product, lose their milk supply, and possibly end up with a failure to thrive baby because they won't all seek my help. 

My theory is that Target purchases the shields in this "regular" size, because they have no idea about the reprucussions of a mother buying an incorrect size. "Regular" sounds right to them. 

I'm surprised this hasn't been a bigger issue in the LC community at large. Are there others out there who see moms coming in with these huge 24mm nipple shields and a basket full of problems as a result of using this product? I see it all the time!! Patients even bring these with them into the hospital.

Brenda Phipps, BS, IBCLC
Flagstaff, AZ

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