In an article I wrote on nipple shields for Clinical Lactation, I raised
more unanswered questions. There are no agreed-upon professional guidelines
or protocols for the use of nipple shields. Many of the studies on nipple
shields are small observational studies without sufficient sampling and
statistically underpowered. Nipple shields could be thought of as a super
stimulus whose attributes such as size, shape, stiffness, and texture could
all modulate the sucking instructions from the suck central pattern
generator as encoded by Merkel cells. Oral tactile input from Merkel cells
that line the lip vermillion and buccal mucosa could encode a nipple shield
rather than a nipple, altering the suck dynamics of the infant during a
critical learning period. This begs the question of should shield use be
avoided during the early hours and days following birth so that the infant
imprints on the maternal nipple and not the shield? Silicone polymer
release is possible from silicone baby items and household objects. The
question here is what is a safe amount of silicone ingestion for an infant?
Nipple shields vary in size and shape, so how do we decide on shield
selection for a particular situation?

Walker, M. (2016). Nipple shields: What we know, what we wish we knew, and
how best to use them. Clinical Lactation, 7(3), 100-107.

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