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Subject:
From:
Janeane Calvert Kuhn <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 1 Oct 2007 21:38:19 -0400
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Hi, my name is Janeane Calvert-Kuhn and I am an Ivy Tech nursing student in Indianapolis, IN.  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?
On a more personal note, can anyone share with me how I can keep my strong opinions in check when a mom seemingly "jumps to the bottle" with little consideration? I know that all we can do is our best to educate, but....... 
Thank you in advance for your patience and opinions on an old issue!
Best wishes, Janeane Calvert-Kuhn

References
Bodley, V. and Powers, D. Long-term nipple shield use - a positive perspective. J Hum Lact 1996; 12(4): 301-04.
Elliot, C. Using a silicone nipple shield to assist a baby unable to latch. J Hum Lact 1996; 12(4): 309-13.
Martin, Jahaan. Nipple pain: Causes, treatments, and remedies. LEAVEN Oct. - Nov. 1999; 10 -11.
Mohrbacher, N. and Stock, J. BREASTFEEDING ANSWER BOOK. Schaumburg, IL: LLLI, 1997; 53, 86, 390, 396, 401, 417, 566.
Searly, C. N. Rethinking the use of nipple shields. J Hum Lact 1996; 12(4): 299-300.

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