Dear Friends:

What an interesting discussion! I agree that a nipple shield is one more
tool that we can use....when necessary. The decision of when "necessary"
occurs should be based on skilled assessment and evaluation.

I do suggest pumping 3-4 times a day in the first 2 weeks (while the
prolactin receptor sites are being primed) in addition to breastfeeding
because Meier's research with premies showed they took in MORE milk with the
shield than without. This was not ENOUGH milk; those premies still needed
complementation. I worked with a mother once who was given a shield in the
hospital; no idea why. When I saw her at 2 weeks,she could have hung a hat
on those nipples! She always saw milk in the shield when the baby came off,
assumed all was well....until a pediatric visit at 1 week. The baby was
hospitalized for FTT. Her supply was compromised; she felt terrible and
there was a lot of work to do to recover breastfeeding.

One thing I have heard a lot and do not understand at all. Many nurses tell
me they use a shield when the mother's nipple is too big for the baby's
mouth, maintaining that breastfeeding is possible with the shield. I do not
understand how making a big nipple bigger is helpful; no one has yet been
able to explain this to me. Yet the practice continues.

One client had large nipples and the 24mm Ameda shield (for some reason,
this one seems slightly bigger than the Medela 24 mm),   always hurt her.
Yet she persevered.

The different sizes are for different nipples. The two have to be congruent
for optimum comfort and milk flow.

warmly,

Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com

             ***********************************************

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