Nikki Lee asks,
 

<<Where is the evidence that thick newborn milk transfers  through a 
shield?>>
 
And I want to know, where is the evidence that it  doesn't?  
 
Until someone actually does a study -- and given that the  amount of 
colostrum is relatively small in the first two days when moms are in  the 
hospital, I'm not sure we are going to be able to ascertain that with the  tools we 
have now.  I'm not sure we can ascertain how much colostrum a baby  gets 
without a shield, let alone with a shield....
 
BUT -- in all this, the most important fact that we are  overlooking is -- 
is the shield being put on appropriately?  Are we fitting  the shield to the 
mom?  Is it so small that it is squashing her nipples and  nothing can come 
out?  Have we just plopped it on the areola with no  thought to making sure 
her nipple -- even a flat nipple -- is seated well in the  shank of the 
shield?  Are we sure the baby is taking a nice big mouthful of  breast tissue 
with the shield, and not just sucking on the teat  portion?
 
Nikki did a great job in a previous post of describing all  this -- and I 
want to say it again, I think many decreases in milk supply are  related to 
the shield not being put on correctly.  I have had many moms get  a shield in 
the hospital, and when I see them and ask them what instructions  they were 
given, they look at me totally blankly -- "instructions?   Really?"  
 
So before we blame the tool itself, let's see what kind of  instructions 
the mom received.  
 
Jan Barger, RN, MA, IBCLC, FILCA
Wheaton IL 

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