I can only report my very limited and subjective experiences asking moms to pump with a shield and without a shield.  They report that placing the shield on the nipple before pumping reduces the vacuum pressure about 40 mmhg.  If a baby has a poor vacuum to start with, using a shield will further reduce the vacuum.  Studies have shown that poor vacuum (such as happens in a baby with cleft palate, etc.) will result in gradual reduction of milk supply due to less than optimal drainage of milk.  What I have observed on the floor is that even when hand-expression is done skillfully, most moms will not express long enough to get peak oxytocin levels and tend to get discouraged.  Therefore, we teach a combination of pumping plus hand-expressing to increase prolactin levels and effectively stimulate milk volumes.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Nikki Lee
Sent: Sunday, February 09, 2014 6:05 AM
Subject: pumping when a shield is used in the hospital.

Dear Lactnet Friends:

The question was asked about pumping when shields are used in the hospital.

This to to ensure maximal stimulation by milk removal so that enough prolactin receptor sites are primed for a mother to make a full supply when her baby is 4 or 5 months old.

This is to ensure that this mother with the shield will not be a mother to have a baby readmitted to the hospital with failure to thrive in the 2nd week of life. This can happen with nipple shield use. There is no way to predict how THIS mother will respond to a barrier between her nipple and her baby's mouth.

Shields do reduce drainage.  Sometimes shields are used for that reason, in the case of oversupply.

Hand expression gets more milk than a pump in the first 48 hours, according to Oyama. All mothers need that skill.


Does anyone know any studies looking at colostrum moving through a shield?

warmly,



--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy* www.nikkileehealth.com https://www.facebook.com/nikkileehealth

*Get my FREE webinar series *

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