Sorry to take so long to respond to this criticism of my earlier suggestion that
babies do not effectively move colostrum with a shield and that shield use might
be reserved for use in moms with a full milk supply.

First of all, I want to say that I am a hospital LC...in an institution that
sees 1500 births a year and has a 70% breastfeeding rate. We have one FTE to
cover this....so I am not walking around on cloud nine somewhere, unaware of
what the "real world of hospitals" is like.

Second, I would like to question what is meant by adequate removal of colustrum
with a shield in place. Are we talking about seeing colustrum in the shield?
Frequent audible swallows? Weight loss of < 10 % at day 4? Milk in by day 4?
Weight beginning to rebound by end of week one? Eight wets and dirties a day?

If someone out there is really seeing all these markers of maternal/ infant well
being, following early introduction of a shield.....I'd be very interested in
seeing your case studies published. I am not saying this to be sarcastic...I
really would like to know.

I have given shields in the hospital for very special and difficult situations
but...never with the above markers being the result. Maybe that is because I am
not giving them out to normal, healthy moms and babies with minor suck problems
that are likely to be resolved. Early introduction of a shield (before mom's
milk is in) has become something I just won't do.

Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati

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