Hi Everyone, I had an incredibly unusual situation last week, that I am still sort of fuming over, although Caoch Smith would say to be "open to change". We use nipple shields in our hospital based practice more than I would like, but can say we have had great sucess with them and provide close followup with anyone being discharged with them as per a certain protocol we've developed. Last week, unbeknownst to me a patient was given an orthodontic nipple to try as a shield by a nursing instructor (at that time) who works as a midwife elswhere, and says they use them "all the time" with great results. I was not able to make contact that day with this brand new person to our hospital (it was her first clinical day as an ADN instructor! It is probably just as well as I was fairly ballistic after the subsequent contact I had with the patient involved. She was determined to use it since it worked so much better than the shield. What to do about it - will be taken care of - I shall "seek first to understand" now that my temper has cooled, and plan to approach her this week. My question is " is any professional IBCLC or even non IBCLC's recommending or using these EVER? Certainly , I know of no evidence-based research that states they are suitable for use, only the research that exists on shields. Since the patient was determined to use this despite my reservations, everything was clearly documented on the patient record. She did have a pump in style at home and agreed to pump hindmilk. Unfortunately, my relationship to the patient was completely compromised because of this instructors actions and the patient refused LC followup, except with her MD, who is not particulary supportive of breastfeeding mothers. How about it anyone...care to comment? P.S And by the way in keeping with the current thread, it was yet another mother who had flat nipples that might have been helped with shells prenatally, skipped prenatal breastfeeding class, who ended up a failed forceps and subsequent vacuum extraction and a baby with a terribly disorganized suck! Some things, just don't seem to change much! _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx *********************************************** 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