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Sun, 15 Apr 2007 17:06:29 EDT |
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Pam, I don't have a written policy where I work but I keep the shields in my
office. The office is locked when I am not there.
I do believe nipple shields have a place in the lactation field but I feel
they are a tool that can be missed used and abused. Therefore this is what I
tell my staff.
Moms should be at least 24 hours postpartum, and preferably closer to 48
hours before a shield is introduced. The rational behind this is that the baby
should have every opportunity to feel and mouth mom's bare skin. This
touching and licking has benefits to both the mother and baby.
Next, colostrum is so thick and comes out in small amounts making it
difficult to be extracted through a shield by the newborn. The baby would receive a
larger dose of colostrum by licking what mom can hand express than through a
shield in these first 2 days. Also, mom hand expressing into a spoon and
feeding her newborn would guarantee more intake than sucking on a shield.
Shields given in the first couple of days make the nursing staff feel good
but this is a false security because the likelihood of the baby actually taking
in any colostrum is very unlikely.
I do not have mothers sign any forms when giving them a shield. I introduce
the tool, describing what it is, why I am recommending it, and how to use
it. If the tool seems to be resolving the problem, than I discuss weaning from
the shield and this may take days, weeks or even sometimes months.
I do not have moms pump when using a shield unless the situation calls for
this measure. If a shield is used correctly, babies can obtain full feedings
without compromising mom's supply.
Any mom requiring a shield should be followed by an LC, so that is why they
are in my office to hopefully their use is under my direction.
Hope this helps.
Ann Perry, RN IBCLC
Boston, MA
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