Jay, I have a similar case...preemie twins doing well with the small
nipple shields and not yet able to latch to the bare breast. Honestly,
this mom has enough milk to feed quads!!! I am telling her to pump a
couple of times a day to make sure she "empties" herself at least then
(more out of concern for plugged ducts than supply). We are, also
watching her supply closely with pre and post weights on the babies
every other day. I can't imagine telling her to pump after every feed,
as it takes so long to feed these two little people anyway.

It seems to me that, when shields are introduced early, before a good
supply is established, there may indeed be concern about the stimulation
being able to build supply....but...after a mom has proved to be a
producer....maybe not as important.

Will be very interested to hear from others in this matter,

Susan Keith-Hergert RN, MS, CPN, IBCLC