hello everybody,
We have had more and more problems with inappropriate use of nipple shields at our facility. We are a midsize Level III hospital delivering about 3000 babies a year. We have LC coverage 7 days a week, one LC for Mom-Baby and one for NICU for the 8 hours of day shift. Currently we stock nipple shields on the floor, and bedside nurses are allowed to initiate the use of a shield. LC staff does follow up with every mom using a shield before discharge, and we recommend weekly wt checks, and LC follow-up within a week of discharge. We do not routinely recommend pumping, in ac effort to keep the process simpler for these moms and babies. I know that in other facilities only the LC can start a baby on a shield.
the biggest problems I see result from
1. edematous breasts due to IV fluids, nipples are flatter, staff is not fully acquainted with Reverse Pressure Softening, so they get desperate to get the kid latched on their shift, and they grab a shield;
2. Baby has a sleepy period and again staff gets nervous about getting the baby to breast, and they start a shield.
I would love to hear from Lactnetters what is going on at other facilities. Can staff nurses start a shield? Or is this left to the LCs? Do you get a written consent? What kind of information is given with shields? What kind of follow-up do you do?
Thanks
martha Johnson Rn IBCLC
SHMC Lactation Service
Eugene OR USA
PS Please email me personally as well as posting the list with your response.
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