I think these have been discussed in the past few months. You might want to check the archives. At one time we did not have any shields available on the OB floor. They could only be obtained from the LCs. That way we could assess whether they were really appropriate and not just pulled off the shelf because the nurse couldn't think of anything else to use or she felt they would solve every possible problem. Later, we did reintroduce them to the supply carts after giving information to all staff nurses about appropriate and inappropriate use. At that time we did make a "consent form" that was more informational than a valid consent. It made sure that the mom was informed she should consider it a temporary aid, that SOME babies don't get as much through the shield as they would if they were nursing effectively at the bare breast, and most important, that she should watch baby's output as long as the shield was needed. If a nurse starts a shield when the LCs aren't there, they pass the form along to the LCs which alerts us to follow up with this mom. We generally follow up by phione at least until she no longer needs the shield or it is obvious that baby is getting plenty of milk with the shield. At that time we leave it to the mom to contact us if she needs further help. If the baby's doctor doesn't schedule the first visit until 2 weeks, we definitely plan to have the mom bring baby for a weight check in 2-3 days. The "consent form" then, in our case, is not so much a legal document as a means of communication-to the mom and to the LC. We have found that for the most part, nurses are now using the shields appropriately. I think they know that if they start misusing them, they will be returned to our office and not be available unless the LC is in. Winnie Mading RNC, IBCLC *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html