I want to thank Jane Lowe for her intelligent and useful discussion of
nipple shields. I share her viewpoints. Nipple shields are tools, like a
hammer or a chisel. As experienced IBCLCs, we know which tool to use in
which situation to get a desired effect. We can insist that any particular
tool is not useful, only to lose a breastfeeding possibility, but this is
really shooting ourselves in the foot. Instead of cursing the tool, we need
to become skilled in the most basic of basics, latch...and then only use
the tool when it is necessary, and that should be seldom. The problem comes
when tools such as nipple shields are used INSTEAD of skilled breastfeeding
help, and this means learning and honing the skills of latch. Also, we need
to understand that each mother is like a surprise package...a lovely
package with an unknown inside, comprised of her experiences, her beliefs,
and her hopes and dreams and fears re: breastfeeding and mothering. What
will work for one mother will bomb with another, and the tool that is great
with one, will not be right for another. This is where the skill comes in.
This is why one cannot learn how to do this work in 5 days. It is a real art.
There is a time and a place for each tool, and we may only need any one
tool once a year, or whatever, but when you need a screwdriver, a hammer
won't do. And it takes time to know which one to pull out in which
situation. It is not the tool that is essentially bad, or the user, but the
lack of judgement that causes us to use tools such as shields when we are
missing the most basic things of all, correct breastfeeding latch
information and technique. Nipple shields should not be used as a
substitute for skilled help, or out of panic because our patient will be
discharged....and is not yet feeding...I know Jack says they shouldn't be
used in the hospital, during the first few days, and this is probably quite
true (excepting babies whose mothers have demonstrated inversions that are
so serious ..etc. rare cases where they have had prior bf failure).
We do not do our patients or our colleagues any service by damning them in
order to gain trust or business, but it is a delicate balance. I have
learned over the years never to say never. We need, as a profession, to
spend less time back biting and making absolute statements, and more time
learning the science of lactation. There is enough work to do to learn
that and uncover the truth of how lactation works to keep us all busy until
we die. It's a lot easier to just carp and complain and backbite...rather
than suck it up and learn what the heck we are doing, what the science
says, and what REALLY is the truth about latch, shields, or whatever.
Kathleen
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
http://together.net/~kbruce/kbbspin.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html
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