Hi folks,

I view nipple shields in much the same category as formula and c-sections--all
three are tools that are useful in some circumstances but should be used as a
last resort rather than a first resort. A hammer is a tool that can be used for
constructive purposes if used correctly, or it can do a heck of a lot of damage.
And using a hammer when a pair of pliers is needed is foolish as well.

I think much of the bad press that surrounds nipple shields has much to do with
the fact that for a long time, bf moms were given them at the first sign of any
problem. They seemed to work at least in the short run, and perhaps the followup
was not there for the folks who gave them out to see the longterm effects. It
was the LLL Leaders and others in the field of helping moms bf who saw what
damage these things could cause if used routinely. Also, the design of these
things has gone from torture instrument to thin and flexible. And the reasons
for using them today are much more narrowly defined than they were.

We always have to look at risk/benefit, too. If a shield will get a baby who
otherwise refuses to go to breast, and IF mom understands the possible negative
effects of using the shield, and IF she knows what signs to look for, and IF she
is taught effective ways to keep baby from being permanently hooked on them,
then the benefit (baby breastfeeds) may outweigh any risks. Notice the active
role of informed consent that is necessary, though.

Melissa Vickers, IBCLC
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