I find it interesting of all the discusion lately on nipple shields no one
mentioned the latest issue of JHL.  The whole journal was on this subject.  I
have always been told that nipple shields were never to be used or for only
the most desperate situation and then cut it down to wean.
As my career as a LC I find the need to be very open minded and this is one
of those times.  In the articles there were responces from some moms who used
the shields.  Many of them said this allowed them to bf their babies and many
would have given up bf if they didn't have the shield.  Most weaned within a
few weeks and none of them were cut.  Also all the articles were on the
silcone shields.
I recently had a mom who had bilateral inverted nipples and a baby with a
tongue and latch problem.  Her breast were small and firm.  She used shells,
inverted syringe and pumping to pull out the nipple but we still could not
get the baby to latch.  She was my first case using the shields (silicone ).
 The baby wasn't crazy about it but would eventually latch and nurse half of
the times the other feeds were cup feedings with pumped milk.  She kept the
baby close and kept trying to get him to latch.  After one week we were able
to get him to latch on both breast and have great feeds!
I will use these again, not frquently and with very close monitoring but let
us remember what our goal is - to get the baby at the breast - what ever way
works.
Sorry for such a long note.