Dear Friends:

Chertok et al just published an article in the J of Pediatrics 2009. The
study has such lovely features as looks at 2 groups of dyads: one in Israel,
and on in the US. Mothers' prolactin levels and baby's weight gains were
monitored when mothers were using nipple shields. The study looks so
attractive.

Until one looks at a table within the study that shows that 40% of babies in
one country, and 45% of babies in the other country were getting formula at
2 weeks; the numbers of babies getting formula increased over the term of
the study.

So how can the researchers claim to say that nipple shield use from the
beginning makes no difference when the percentage of exclusive breastfeeders
is unacknowledged, and breastfeeding is not defined?

Based on my knowledge of lactation physiology, I suggest that mothers pump 3
or 4 times a day in addition to breastfeeding if they come home from the
hospital using nipple shields. I want to maximize the prolactin receptors.

Meier showed that premies transferred MORE with the shield, and the amount
was still insufficient. As so many babies are preterm in the "term" nursery
(all those late pre-terms that arrived via induction), nipples shields may
be increasingly important. And the mom needs to pump for a few weeks.

Once the baby is reliably nursing and gaining weight and as they mature
(remember that the film "Elk and Epidural" suggests babies will start to act
naturally 6 weeks after they were born if an epidural was using in labor),
the shield will probably get forgotten or lost or outgrown, as someone has
already mentioned.

I worked with one mother that used a Davol shield with a rigid plastic base
and a bottle teat on that....she breastfed 2 kids over a year each. She had
no muscles to make an erect nipple.....only holes. She leaked 2-4 ounces
each feed, plus fed her babies. Very unusual case.

One mother from India that had her baby readmitted in the 2nd week for
failure to thrive had been nursing wonderfully, and saw milk in the shield
after each feed. It just wasn't enough....

What do you all think?

warmly,

Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com

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