I appreciate everyone's input into the nipple shield question. I still
maintain that starting a nipple shield before the mother's milk is abundant
is poor practice, since it does not give time a chance.

I do see young babies, under three days of age, though not as often as
hospital based LC's, but I can tell you that with practice, you can get many
of these babies on the breast and breastfeeding by getting them on with a
lactation aid after a minute or two of finger feeding.

This shows the mother the baby can latch on, and makes it easier for the
baby to latch on later. You hospital based LC's mustn't forget those of us
that are faced with a mother of a 7 or 10 day old using a nipple shield. It
is my feeling (not proved) that it is easier to get a baby latched on who
has been on a bottle than on a nipple shield. (And easier still, if the baby
is finger feeding or cup feeding, but that's another story). The main
determinant of getting a baby to take the breast is if the mother has a good
supply, the more the more likely the baby is to latch on eventually. A
nipple shield can seriously interfere with milk supply, since often the baby
is not really stimulating the breast, only pretending. If the mother has an
abundant milk supply, the baby eventually will take the breast, no matter
how he is fed, between 4 and 8 weeks of age. I do not find this to be the
case, however, when the baby has been feeding on a nipple shield.

The exception is when nothing else has worked, I will often start the nipple
shield when the baby is 2 or 3 weeks of age. This seems to change something
for many babies and then they latch on after a week or so on the nipple
shield. I do not do this very often, even though I see many many babies who
don't latch on, often 5 or 6 in a single day. Because with good latching
technique, most babies will latch on.

Jack Newman, MD, FRCPC

             ***********************************************
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