Please preserve us from nipple shields.  They are almost never
necessary, no matter what sorts of nonsense is being said about them.
And they are almost never necessary for premature babies, an approach
which is being pushed because we lack the patience to take the time for
the premature babies to get the hang of breastfeeding.  And also because
we do not start the premies at the breast early enough.

        When we do need nipple shields, it is because we have not yet developed
the skills to do without them.  I too occasionally, repeat occasionally,
will suggest one when all other things have not worked, but I still
consider that when I suggest a nipple shield, it is because I just did
not have the right approach or the necessary skills to help the mother.

        In any case, using a nipple shield within days of birth is absolutely
contraindicated!!!!  If they are to be used, only once an abundant milk
supply is assured without reservation.  I challenge anyone to a duel who
says otherwise.  Nipple shields at ten paces.

Jack Newman, MD, FRCPC