I am really concerned about all these moms who are given nipple shields and not able to get off of them. It looks like the "indication" for use of a nipple shield has changed from supposedly helping with sore nipples, to helping with latch problems. It is not a good sign, when the indication for an intervention changes, especially without an interruption in the use of it. What you end up with is the intervention having come before the indication! My experience with nipple shields is different than most, so I thought perhaps I could suggest something that might help with these babies who get stuck on a shield and can't get off. These things are probably more likely to help with a baby who is a few months old, but may help with a younger baby too. There can be more than one reason the baby is not willing to try latch right onto the breast, without the shield. I used a nipple shield as a step in getting my daughter, Julia, whom I adopted at six months old, nursing, and have since been in contact with several other adoptive moms who have used a nipple shield as one step in taking an older baby from bottle to breast. Prior to using the nipple shield, I had fed her with a wide-based bottle nipple which had a SNS tube threaded through it, so that when she sucked on the nipple, she got the milk from the SNS bottle. The advantage of this was so that I could get her used to feeding in an exact position as for nursing. Once she was comfortable with that position, I tried moving the bottle nipple, once she was settled in and still sucking, half asleep. She would open her mouth and search for a nipple but, when I tried to get her to take my breast, she would close her mouth as soon as her tongue touched my skin. What helped was an Ameda-Egnell latex nipple shield, which was a very thin shield that did not have a firm "bulb" on it like the brand new (at that time) Medela silicone shields. It tasted like the bottle nipple, but comformed more to the shape of my breast. After using it for a few days, I moved it one day and she finally latched onto my breast. Another adoptive mom with an older baby used a nipple shield, which she cut down to expose ever more breast. She started cutting from the outer edge of the shield, not the tip, until the last piece was where his tongue touched the breast (I believe she hung onto it at this point to make sure he couldn't swallow it). Now, this was a latex shield, too. I have heard some suggestions for cutting down a silicone shield, but I have never been able to do it without leaving a noticably sharp edge. I know that most of these moms now are using silicone shields, so these exact measures might not work as well, but I am offering them as examples that may help someome come up with ideas. Here are a few additional suggestions: Try to move the shield after the baby is pretty much fed, half asleep, and contentedly sucking. Many babies will open their mouths and search, without opening their eyes, which can provide an opportunity to get the breast in there. (Another advantage of trying to move the shield in the middle of a nursing session is that the nipple may be standing out a bit more than it otherwise would). If the baby takes the breast when half asleep, he may take it next time, while awake, or it may take a few times making the change in the middle of a nursing session. Do not try to make a change in feeding experience when the baby is hungry or otherwise agitated. Pick a calm time to try. If the baby starts to get upset, give him what he wants and then try again later. In general, with older adopted babies, we have found it best to wait a day or more before trying again, if the baby has gotten upset with a change attempt. Take the attitude that the baby wants the bare breast, but just doesn't know it yet, rather than that the baby just plain doesn't want the breast without the shield. The baby has been confused into thinking that a nipple shield is "supposed" to be there. Even many of our older adopted babies who have had very negative responses to the breast, at first, have learned to love the bare breast, and even gone on to nurse for extended periods. (However, negative experiences are best avoided where possible!) Have the mother rinse her nipple and areola prior to doing this, to get off any salt or other substance that might flavor her skin and disturb the baby. I do not know if the flavor factor figures in with alot of babies or not, but it does with some, so this is worth a try. Bottom line, hang in there and keep trying, but don't feel like the change has to take place immediately. A sense of urgency will only work against both mother and baby. Use patience and creativity. Emphasize the advantages of making the change (greater ease in nursing, better milk supply, etc.), so mother sees that it will be worth the effort. Perhaps telling the mother about adoptive moms' experiences might help, on occasion. We have an advantage in that we expect nursing our babies to be challenging, and have also usually developed a pioneering spirit, in our quest to become mothers. This should not be related in a way that trivializes the bio mom's challenge, but which emphasizes the idea that, if there is a will, there is a way! Aloha, Darillyn _________________________________________________________________ The new MSN 8: smart spam protection and 2 months FREE* http://join.msn.com/?page=features/junkmail *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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