I have been a hospital based lactation consultant for almost two years. I have been wondering lately if woman with small areola are more likely to get sore nipples. I have noticed this on a few patients and I think it's harder to get the nipple back further into the mouth if areola is very small. Does anyone have any insight on this. Also on a slightly different subject, how does one determine  when to use a nipple shield. I used to feel guilty everytime I used one feeling like I'm taking the easy way out, but now I use one more often if I really can't get a baby on, but also warn the patient to follow up with me after D/C. Is it sometimes harder to reteach a baby to nurse without the shield once they've learned with it?
Stephanie Sperling RN IBCLC
Brandon, Florida
  

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