>>In our state we are careful not to make a gadget from an appliance intended for another use. We could set ourselves up for malpractice suits.<< Trina, The "gadget" that I referred to was written up as a full article in JHL. Indeed, if I can't use an inverted syringe to help pull out a nipple, then maybe we shouldn't use a breast pump, either, as that is not its intended use?! I fully understand what you are saying, and I live in the same state that you do, but if I followed that precept to the letter, nothing would ever evolve in our field. There has to be some room for experimentation when the "proper tools" just don't exist. Even doctors do this! Regarding your use of a nipple shield to achieve the same purpose: there is often more than one way to skin a cat, as they say. However, nipple shields are not without their risks, to the point that some on lactnet use informed consent forms before utilizing them. Maybe we each need to work with what we are most comfortable and successful with? -Lisa Marasco, BA, LLLL, IBCLC