Hi Karen,
I work in an NICU in Victoria, BC, Canada. We  have no policies on 
breastfeeding of prems but are starting to work on it. The focus is bottle 
and get them out the door. I'm wondering if it would be at all possible to 
send me a copy of your hospital policies around introduction of 
breastfeeding. Do you have a policy on introduction of the shield. We seem 
to have an awful lot of moms using shields when really there is no grounds 
for it; and the moms become very dependent on them, when they really don't 
need one in the first place. Any info you can pass on to me would be 
wonderful. Thanks so much.
Sincerely,
Tammy Timms, RN, IBCLC, BSN
[log in to unmask]

>From: Karen Palmer <[log in to unmask]>
>Reply-To: Lactation Information and Discussion              
><[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: Nipple shield for preterm infants
>Date: Tue, 11 Jul 2006 14:33:52 +1200
>
>Hi Leslie,
>
>Nice to see your post.  (Leslie and her husband came to visit our neck
>of the woods earlier this year).
>
>Most of our prem babies go from naso gastric tube feedings to straight
>breastfeeding.  This will be done in increments as the baby matures.
>Our hospital policy states a breastfed baby may not be given bottle
>feeds -  (sometimes there are exceptions to this).  They may start with
>one breastfeed a day, then two, then alternate, etc.
>
>Nipple shields are only used when latching is not easily achieved.
>
>NZ prem babies probably go home later than in other places around the
>world.  In fact our problem is getting them out of NICU, when they are
>probably ready to go home sooner!  But that is another story.
>
>Karen Palmer
>New Zealand
>
>
> >>> [log in to unmask] 07/11/06 6:44  >>>
>Dear wise women
>I have searched the archives of Lactent for info concerning the use of
>nipple shields for preterm infants.
>The 2000 article from Human Lactation was quoted a few times, but that
>was a trial study done 7 years ago on 34 babies.  I am very interested
>in hearing from IBCLC's that work in the NICU ..1. .do you have mothers
>breastfeeding often without giving any bottles before hand? (once the
>infant seems capable?) 2.   do you use nipple shields when starting
>mothers on breastfeeding?  I would be most appreciative to get feedback
>in this subject.  You may write to me by way of the group or privately.
>Close to the Heart
>Leslie Wolff  [log in to unmask]
>Israel
>
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