Dear Debbie, I much appreciated your frank discussion of nipple shields. I have only used them once myself, after working with a mom for 2 1/2 weeks at repeated home visits. This mom had a copious milk supply, had an electric pump and I felt she was a good candidate for keeping her supply up without too much extra effort. Eventually her baby did go back to BF and I think the act of feeding her baby at the breast helped her to hang in there until he was ready. I have also seen babies (not my clients) get hooked & moms continue to use the shields as their milk supplies gradually dwindle. A large portion of my practice consists of nipple confusion cases and I have wondered if I should be more ready to suggest nipple shields. It seems in many cases that if a mom has already used a bottle, which led to complication of her BF problem in the first place, she is more likely to get burned out on alternative feeding and decide to wean. Your guidelines for use in your practice sound reasonable. Would you send me a copy of you consent form through e-mail if you have it on disc? As an LLLL, I had learned that nipple shields are a no-no and used by the misinformed. However, I try to keep an open mind about different methods & tools, as I believe we have to use whatever works for the mom & baby we are working with and no one technique works for everyone. After reading your post, I'm rethinking my prejudice against nipple shields. Looking forward to the JHL addressing this issue. Love to hear other comments on this issue. Ro K. Andersen, IBCLC, LLL, voting that we keep Debbie in our ranks Winchester (near Boston), Massachusetts, USA Ro [log in to unmask]