Janeane,
You have brought up some points that we (the group I work with) have been looking at recently. We have just requested a lit search to see what the latest studies reveal about nipple shields. Your personal experience with a shield ('a gift from God") is not unusual. We see women coming in to the hospital with nipple shields packed in their bags because a friend told them they should have it. Your reluctance to give it up is easy to understand. With significant nipple damage, there is significant pain. Since the shield relieved the pain, giving it up may mean the pain might return. What new mom wouldn't want to continue the use of the shield? 

I think that the bad reputation of nipple shields stems from the old shields that really did have a high incidence of low milk supply due to the materials the shields were composed of.?Some were made of thick rubber, some had a?glass base with a rubber nipple. The misuse & overuse are certainly concerns. Babies can have poor latch with a shield which can cause sore nipples & decreased milk supply.

There are many opinions about the use of shields, re:?using at all or when to initiate their use. More studies?need to be done and case studies need to be published. Lactation consultants need more education about shields, how long to wait for babies to latch, ways to get babies latched and use of alternative feeding methods. Labor and birth practices need to be considered in the case of babies who don't latch and the how this should be handled. Do we use bottles, finger feeds, cups or?spoons to feed the breastfed baby who won't latch? If a baby will latch with a shield, is this preferred over having the mother pumping and using alternative feeding method? What, if any, are the legal issues with professionals recommending the use of shields? 

I certainly have a lot more questions than answers about the use of nipple shields. I do use them-many times they work well, sometimes they don't. Thanks for bringing up this topic. I'll be interested to see what others have to say.

Laura Hart, BSN, RN, IBCLC
Hospital-based in Winter Park, Florida




I have been reading about the use of nipple shields and am amazed at the difference of opinion available in research. I was given one with my first son after having some significant nipple damage due to a poor
latch. At the time, I felt it was a gift from God but my focus quickly turned to keeping this precious 
little thing safe and sound for the next feeding! My IBCLC insisted on short term use and although I 
kept it longer than she wished, I did relinquish it in time (more than three weeks!). There are reports
that even the thin silicone nipple shields cause reduced milk intake and present a potential for reduced 
maternal milk supply and nipple damage with improper placement. Does their bad reputation perhaps have 
more to do with misuse than proper use--and proper use with the knowledge of potential risks?
Is it more an issue of their wide availability and/or potentially untrained or inexperienced staff who 
cannot get an infant to latch on to the breast who may introduce them in the hospital to help the infant 
breastfeed before being discharged versus a simply good or bad label?  Don't they have their place
in the right situation (flat nipples, prematurity, etc.), with the close guidance of an experienced 
lactation expert?

Thank you in advance for your patience and opinions on an old issue!

Best wishes, Janeane Calvert-Kuhn





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