HI Jan, First I try to avoid nipple shields until babies are at least 24 hours old and feel licking a bare nipple with expressed colostrum is more beneficial to both. Next I do not routinely have a mother pump when using a shield. I do follow them and if I find the milk supply is not where it should be or the baby is still not a great nurser even with the shield then I have a mother pump. It is a case by case basis. I do have the mother stim her nipple prior to placing the shield on. I teach them hand stim but if they have a pump and want to use that first they could. Ann Perry RN, IBCLC Boston, MA *********************************************** 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