Hi.

I am attempting to write an education session/protocol for staff on a post-
natal ward regarding the use of nipple shields. I work in an area where 
they are reccommended frequently, both on the post-natal ward and by child 
health nurses. Many women who have breastfed well initially, and go on to 
have a rough couple of days (!!!) go straight to the chemist and buy a 
nipple shield. We have many women coming back to our (small and under-
staffed) breastfeeding clinic,who have all the problems which we know are 
associated with shield use. I would love to get rid of nipple shields all 
together (!!!), or have a system by which only trained bf 
counsellors/IBCLCs "prescribe" them, when appropriate and with good follow-
up. My goal for now is to reduce their use a little (heres hoping), and to 
put better advise in place for women who use them.

My question is: what do other IBCLCs say about nipple shield use and 
pumping: 
Routine pumping or pump if there are signs of reduced milk transfer/reduced 
breast emptying?

I favour advising women to hire a hospital grade pump and express after 
feeds 4-6 times per 24 hours: less or more as needed depending on signs of 
intake in the baby/breast softening etc. My theory is that by encouraging 
women to pump at the onset of nipple shield use, they will avoid engorged 
breasts and reduced milk supply in the long-term. 

Correct or overkill? Can anyone direct me to an article which supports this?

Also any opinions/references about the idea of stuffing the shield with a 
small piece of cotton material as a way of reducing flow and weaning baby 
off the shield? (Can not remember where i read this one!)

Zab Franklin.

Sweden.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html