Hi All,
I'm not interested in any kind of an adversarial relationship on Lactnet or otherwise, however, to say that a nipple shield should be the last resort implies that it is the first step for RN's/LC's and does not take in to consideration the environment an RN/LC is working in. We are taught to assess, plan, implement, reevaluate. Our mother's are taught to STS and are encouraged to do this as long as possible to achieve a latch. Nikki, when do you see the clients? Are you there in the beginning, fresh out of the womb, are they highly educated and motivated or are they of the lower socioeconomic level where breastfeeding is a good thing to do but perceived as too difficult and the bottle is easy. I've been and IBCLC since 1987, I remember the days of using a nipple from a bottle or the precurser of the nipple shield with a difficult latch. Mother's had less medicated deliveries and they stayed in the hospital longer. Now they almost always have epidurals and depending on the time of the delivery, they are out of the hospital in 48 hrs or less and 72 hrs with a C-section.
The nipple shield rant on today's post is a sad situation and to blame the nipple shield is, in my opinion, very short sighted. The nurse did what she could to get the baby latched, she must have done a good job because the baby never received formula. If giving her a shield when all else failed  is how can help a mother achieve her goal to breastfeed her baby, I won't apologize for it. I'll help her wean the baby from the shield and support her where she is at, not where I want her to be.
Just for the heck of it I looked up the definition of breastfeeding and the medical-dictionary.thefreedictionary.com/breastfeeding fefines it as 
"the method of feeding a baby with milk directly from the mother's breast." 


Christine A Raasch, BSN, RN, CLC, IBCLC
Menomonee Falls WI

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