To my dismay, several of the nurses where I work will use a bottle nipple over
mom's breast as a last ditch resort to restore some sort of breastfeeding when
a baby refuses the breast due to bottle exposure.  I have had several moms
come into my nursing mother's meetings doing this and I switch them to the
M*****
shield and wean  off it as fast as I can, BUT in one case the baby would not
latch with the medela shield, only with the bottle nipple over the breast.
Let down did occur and I could hear good swallowing, so I gulped and told mom
to continue but to watch the baby's wets and stools and come back in two days
for a weight check, then we did it in four days and then weekly.  I encouraged
mom to pump three times a day just to maintain supply.  This kid gained 9 oz
in one week and kept gaining, and after about three weeks with lots of skin to
skin contact and a supportive husband, this baby weaned to bare breast
nursing.  Baby is now eight months old and still nursing--I just heard from
mom this week.  Just thought I'd throw this into our discussion.  I am NOT
endorsing it, in fact, I keep trying to teach the nurses not to do it at all,
just saying you have to look at each Mom and baby.