Working in a WIC setting, I often have one chance to get a baby to breast that has never taken it before.  In the 8 years I have been with WIC I have had only 3-4 moms willing to cup or finger feed a baby.  By 4-9 weeks pp, our mom's are happily bottle feeding if there is no latch on within the first week or two!  I use a nipple shield with nipple confused babies very often.  It has rarely resulted in decreased supply.  On the contrary, I find mom's supply increased with frequent feedings using a shield. The worst case scenario is that the mom just quits, but she wasn't breastfeeding to begin with so there is nothing lost.  I wonder if we are using different types of shields?  I follow up carefully and most times these babies are back on the breast, without the shield in 1-3 weeks.  I know there is lots of controversy but I have such great success with them.  Our breastfeeding numbers are very good compared with other agencies and our duration numbers are better than most.  I think the judicious use of nipple shields have really helped!
IMHO
Barbara Leshin-Zucker, IBCLC
Breastfeeding Coordinator
Morrisania WIC, Bronx, NY

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