I feel it is an inappropriate practice. I sent out a strong memo about this
very practice. I have it at work so if you need a copy let me know. I can
get it Monday. I feel it is inappropriate because:
1. I believe the baby could possibly choke on this nipple. 2. I believe the
baby could be just 'sucking air' and not really transferring milk, to
everyone's detriment. 3. If this practice continues after d/c the baby could
be in real trouble (not getting milk). 4. It does not address the cause of
the no latch problem (is it tongue-tie? is it inverted nipples? etc). 5. The
nurse did not recommend expressing, which I feel should be done for a
non-latching baby.

It is interesting to me that my co-worker works at another hospital on
Saturdays. Nipple shield use is rampant there and the LCs and mgrs have met
about how to control their indiscriminate use. I have worked at a hosp for
2.5 yrs now and we do not have nipple shields (actually we do now, having
just bought another hosp last month, and they gave us their supply, but I
haven't used one yet). I have managed without them for 2.5 yrs. Very rarely,
maybe once or twice, I really wished I had one. I remember one dyad with a
severely tongue-tied infant and a mother w/ severely inv. nipples post c/s
birth. Not sure if a shield would have helped anyway. What I am trying to
say is that approach (bottle nipple over mom's nipple) is a band-aid
approach that just wastes time in my opinion. I think it causes more harm
than good.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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