Dear Jan, I think you were right on track. Whether it be pumps, supplementers, or nipple shields; they should be used appropriately and only when required to preserve the breastfeeding relationship. We should not let our bias for or against shields get in the way of helping the mother in the best way. I use nipple shields only a few times a year - usually for refusing the breast. Sometimes a shield makes the difference between breastfeeding or not. I don't like them - probably from years of trying to wean babies who were hooked on them. Because of this bias I sometimes have waited too long to suggest a shield and the mom quit. Now I inform the mother of potential benefit and/or harm and include her in the choice... sometimes they STILL quit. Such is life. Lana Matthews IBCLC Ottawa, Ontario Canada ###