>I've played around with the regular newborn nipple shields from Medela, and
>can't say I've had terrific success with them.  Babies often seem to slide
>right off the end, as if they can't get their mouth around the whole thing.
>
>I just ordered "newborn small" shields (#89905S) on the advice of an LC
>friend, and the smaller teat looks as if it may work better for some
>babies, allowing them to get well onto the breast instead of having their
>mouth filled with the firm part to the point that they can't reach the
>breast.

Diane, so far we haven't seen anything other than the standard size here in
Australia as far as I know. In my experience with nipple shields in
general, I have always felt that if a baby is having trouble getting enough
breast tissue into his mouth for good attachment, that adding an extra
layer of plastic is only going to make it worse. Then it is common to see
them just sucking on the end like on a bottle teat, or sliding off. This is
often where nipple shields earn their poor reputation, as the baby does not
milk the breast properly. In other instances where use of a nipple shield
may be indicated, the length of the firm 'cone' is usually OK (although
there is at least one rubber brand that is very long and may cause baby to
gag), providing a firm pressure on the baby's palate to help elicit the
suck reflex. In all instances, if they are to be used successfully, the
baby needs to be compressing the sinuses through the soft flat part of the
shield, and attachment should look the same as if the shield wasn't there.
The flat part of the shield will wrinkle as the baby sucks.

I would be interested in how the smaller nipple shield you mentioned goes,
and whether there are particular babies that it suits.

Joy Anderson IBCLC, NMAA Breastfeeding Counsellor
Perth, Western Australia
[log in to unmask]