<To generalize that nipple shields are overused is not acknowledging the setting we all practice in and what we are faced with.
If you're not working in the hospital setting, please respect those of us who are who are doing the best we can do in the 48 to 72 hours we have to get the mom and baby on the road to breastfeeding.

Christine, RN, IBCLC>

Well put, Christine.  Thank you for your response.   Working in the hospital setting is quite unique.   There are so many factors involved in the care of the mom and baby in the first 2-4 days of life in a medical setting.   We are working with healthy and medically complicated patients.   We are working with champion breastfeeding supportive staff, and some staff that are not as proficient.  We are working with mothers that express commitment right from the start, and mothers that are "on the fence."  There are supportive husbands and families, and then there are family members who keep telling mom to give formula.  We are working with physicians who are inclined to support breastfeeding and LC staff, and physicians who are inclined to supplement and make their own feeding plans.   I've literally had a physician directly tell a mom to use a shield, without consulting lactation staff.   Some days are quiet, and moms get a lot of individual attention; other days are so busy that we must triage who we see and how long we spend with each patient.   

Follow up is CRUCIAL, and we always refer moms for follow-up lactation support if they have any breastfeeding complications, including the use of a shield.   While I'm not suggesting that we ignore obvious problems with lactation care in the hospital, I would ask that those of you who work in the community, partner with the lactation staff at the hospital.  Reach out to them; ask to meet with them and discuss a case you have concerns about.  They are often in a good position to promote changes in practice.  It's super disheartening to hear that folks in the community are giving the message to moms that they have been poorly cared for, when most of us are working hard to help them be successful.  

Mary Foley RN BSN IBCLC
IBCLC x 28 years; Hospital Practice x 15 years
Melrose, MA

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