> 
> This topic continues to go round and round. We should not be so absolute to say never use nipple shields. Too often I have seen many clients who have been seen by others who have totally refused to talk about nipple shields and their babies were not latching and they had wanted to just give up and go to formula. Someone else mentioned this as well and I agree that I much prefer nipple shields over formula and breaking the breastfeeding bond but will not suggest the use of a shield without making sure I can follow them until they no longer need it or if they can watch their supply. Usually it takes only 1 to 2 weeks and for the nipples that are really big it may take longer but that is ok.
> Another problem I am having though too is the size of the nipple shield? every one seems to be using the small ones who cannot be everted well over the nipple to make proper contact or to stay deeply over the nipple and areola. If it is need the nipple shield should help the dyad not hinder the situation. 
> 
> we need to follow up follow up and follow up some more.
> Attie Sandink RN, IBCLC
> 

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