I mainly see women in the hospital Day 1 and 2 when they have colostrum. I have wondered too, how well do you find that colostrum transfers through the nipple shield?

I worry that probably very little colostrum transfers with the shield. I have also changed from my former LLLL mindset of hatred for nipple shields, to thinking that they may be useful in some situations but generally still see them widely overused by nursing staff. 

If a mother needs to use a shield initially during the colostral phase, I will usually have her also hand express and spoon feed her colostrum because I don't think the baby will likely get enough colostrum and she is therefore at risk of low milk supply too. 

If she is using a shield later during mature milk production, we talk extensively about how to know the baby is getting enough, normal weight gain, how to wean the baby off the shield, etc. I do think most babies will be able to get adequate milk transfer with the shield, but there are some who won't, so mom should be well educated about adequate weight gain.

Tricia Shamblin, RN, IBCLC


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