Hi Brook
While I see the ongoing use of nipple shields as a nuisance, I had one
woman who gave birth to number five baby and the midwives asked me to
see her as she had brought in nipple shields to use. 

So I popped in and during our chat simply said you are aware that you
really don't need to use nipple shields these days. Her response was
that she did not like the sensation of the baby's tongue on the breast
so she used nipple shields with all her other children and breastfed for
9 -12 months for each.

As I had helped her with the first baby and introduced the nipple
shield for feeding problems I also learnt something more about the long
term impact of my actions.

My only concern is that if a nipple shield is introduced early, it may
mask sucking problems so follow up is vital. Other than that it is up to
the mother and baby about how long they use them. I do suggest they try
without them when they are ready. 

Of course I give more information than this but I tend to keep a
relaxed approach to it.
I hope this is of some help
Gwen

From Brook

Is there an evidence-based answer to when and if one needs to
wean from a nipple shield. If baby is thriving and mom is content,
is there any rush? Are there any documented negative effects
of using a shield for an extended period of time--or even for
the duration of breastfeeding? I know in the past that the old-school
shields caused milk-transfer issues and led to a lot of poor
infant weight gain. But I am wondering about the newer silicone
shields. 

I can imagine why many moms might wish to wean from them when
it becomes possible to do so--convenience, removing the "barrier"
between them and their little one, getting rid of the feeling
that a crutch is needed, etc.

But I was faced with the question today about when or whether
it is necessary to wean the baby off of nipple shields and realized
that while all the literature I looked at indicated that we should
always have an eye towards weaning from them, no one ever really
articulated why.

I understand the risk of a woman who has not been educated on
proper use having issues with milk supply and infant weight gain.
But when used properly and appropriately and successfully, do
the silicone shields really carry any longterm risks? Are there
any oral development issues to consider when using longterm?

Beyond the obvious psychological and aesthetic benefits of being
able to nurse without a shield, I'm wondering if there are any
concrete reasons why a mother should wean her baby from them
if she doesn't want to. And if so, at what point is ideal.

Thanks in advance for your thoughts!

Best,
Brooke Casey
Northern California, USA

Gwen Moody
CNC Postnatal Care
Westmead Hospital
PO Box 533 Wentworthville 2145
Phone: 02 9845 6964, 0422212774
Fax: 02 9845 8340
Page: 02 9845 5555 - 01135
email: [log in to unmask]

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