Pat and Jeannette,

    I agree with what you both said re nipple shield use in the hospital.
Jeannette, the three case scenarios you described are almost identical to
ones for which we've found a nipple shield helpful.  And Pat is so right that
"you have to be there."  BTW, when babies are latched correctly, we have seen
colostrum in the shield from the first day on.  As for long-term use and milk
supply, we caution mothers to monitor urine/stool output and weight gain
carefully and to pump and feed additional milk if baby is not getting enough
with shield.  Again, we have usually not found milk supply/weight gain to be
a problem if the babies are latching on properly and feeding often enough.
We worked with one woman whose child nursed only with a silicone shield for
well over a year.  Her milk supply was copious.  In analyzing her situation
with her, in retrospect, we feel that because of the tremendous
oversupply--which she did try to control in other ways, unsuccessfully--her
little daughter was better able to handle the milk flow with the shield and
therefore preferred nursing with it.

Ruth DeRosa, Frederick,  Maryland

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