Jay wrote:
>Would you worry about this moms milk supply using the nipple shield long term?

Not as long as babies are attaching *properly* to the breast.

>If the mother(any mother using a nipple shield) is not protecting her milk
>supply in some way (ex. herbs, pumping after feeds, etc) how long would it
>be (in general) before she would see a drop in the milk supply?

Maybe never, see above.

>If the milk supply is based on supply - demand and a baby is able to gets
>what s/he needs at breast every feed while using the shield, then why would
>the milk supply drop because of the shield?  If the demand is there then the
>supply should also be there even with a shield right?

*Right!* Yeah!

I find it rather frustrating that nipple shields have such a bad
reputation. Sure, I agree that they can be bad news if not used correctly,
and if they are dished out in place of good help, but a *well-latched-on*
baby will be able to drain the breast as well as one without a shield. The
only difference is that it may take a bit longer for the feed as the flow
rate may be slower as the milk goes through the holes in the shield.

I believe that the main problem with shields comes when the baby is just
'hanging off the end' (attaching only to the cone part) and not attaching
properly. The baby's jaws need to be working over and wrinkling the flat
part of the shield. With the former, the supply is likely to diminish
because the breast is not being drained properly - ie autocrine system is
not permitted to work. It has really nothing to do with 'stimulation of the
nipple/areola' - it has only to do with how much milk is removed from the
breast - that is the essence of the autocrine control of milk synthesis.

With mums already using shields, I make a big deal of babies looking and
acting the same on the breast with the shield as they would without - mouth
wide open, good seal, chin in hard, you know... If they don't - ie they are
'hanging off the end', then the shield should not be used - it is the
*wrong tool*. It is in these latter cases that supply tends to suffer.

The fact that this mum of Jay's is using shields to protect her nipples
which are sore from a reason *other* than what the babies are doing (ie
babies are attaching well, not traumatising nipples per se) means that the
babies *are* attaching properly and draining the breast well and therefore
the supply should not suffer.

Boy, can you tell I feel quite strongly about this subject?? ;-)

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Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
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