Anne,

As an in hospital IBCLC and RN, I would like to respond to your statement - 

"The nipple shield is wonderful for nurses because they can give it to the mom, baby will latch, and the nurse does not have to hang around to help the baby latch any further...her job is done."

I don't believe that nurses are using nipple shields just because they don't want to hang around and help moms.  In fact, most of the nurses I know DO wish they COULD hang around and help moms more!   In reality, the nurse is often faced with a baby who can't latch, a physician who is unhappy with letting a baby go 24 hours without latching,  difficulty expressing colostrum, a baby with a tongue-tie that we can't get seen immediately, a mom who is asking for a bottle, AND limited time AND other moms and babies to care for.   Yes, sometimes they turn to the shield as a tool to help.  When one of our IBCLCs then consults with the mom, we can evaluate the situation further and make recommendations.  Sometimes we discontinue the shield, but other times we agree with the plan and mom will continue to use the shield, and we will follow up with her.  Most of the babies we see are off the shield within a couple of weeks.  We've educated our staff well and they know the risks and benefits of the nipple shield.  

As Jillian states so well:  "So in my practice, Nipple Shields are a short term tool used to treat a specific issue and used to help restore Mom's faltering confidence.  I firmly believe Mom's confidence level is every bit as important as any imprinting on the baby, and each mother-baby couplet must be carefully evaluated to craft the most appropriate care plan."  I agree.  We need to find balance - not overusing the shield, but also not treating it as an inappropriate tool only used by those who don't want to hang around and help moms.



In addition, I believe there is evidence to support using a shield temporarily without adding pumping.

Chertok IRA. Reexamination of ultra-thin nipple shield use, infant growth and maternal satisfaction. J Clin Nurs. 2009;18:2949–2955.



Mary Foley RN IBCLC

MA

 





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