My experience is much the same. I think of it as a therapy for our NICU babies, just like a ventilator or a feeding tube. It is something they need to feed until they are developmentally capable of doing it on their own.
We followed about 40 mothers several years ago after we began using nipple shields. Only one baby was unable to breastfeed without a shield after 42 weeks CGA. He also couldn't bottlefeed well or even feed with the shield in place very well. His issues had nothing to do with the nipple shield. I am sorry to say that we did not continue calling this mother to see what happened down the road to see what happened further.
Maureen Allen RN, BSN, IBCLC
-----Original Message-----
From: Fritzi Drosten, RN, IBCLC <[log in to unmask]>
To: [log in to unmask]
Sent: Tue, 13 Sep 2005 00:45:01 EDT
Subject: Nipple shields
I have used nipple shields with NICU selected premature infants for several
years and in my experience it helps them learn to breastfeed. Mothers go home
with the understanding that they will work to get them off using the shield by
close to term(40 weeks), Some of them are off before they go home.
I would think that if you have problems with foremilk and hind milk
imbalance, Joanna, maybe the mothers do not need to "always pump. " You may be
keeping the mother in overproduction, by having her pump too much.
An infant may be capable of feeding quite well with a shield until strong
enough to feed without it. Size is important...it needs to fit mother to baby.
Babies' maximum vacuum levels are not very high. Using the shield is like using
a gripper on a bottle top so you can have enough strength to open it. They
still need to learn to open their mouth wide, and shields don't elicit very wide
gapes, so they still have to work to do to learn how to feed without it, but
it sure beats pumping when it works well. I don't use tubes with shields very
much, since so many mothers don't like them, and staff uses bottles, so they
get bottles if the intake at breast is insufficient after they go home(pumping
then would be a given).
Fritzi Drosten
SFbay area
Piedmont, CA
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