This discussion is stimulating and timeous.  I have always believed that the 
nipple shield has its uses, but is largely abused - given out like candy in 
our hospital!  With patience, KMC and maybe expressing colostrum into a 
teaspoon, most babies do latch well in the first day or two.  Especially 
when dealing with the disorganised babies that we see so often.

Well, never say never!  Yesterday I ordered a nipple shield for a mother 
after the very first feed!  Visually her breasts and nipples appeared 
perfect for breastfeeding, but her rooting newborn could not stay attached. 
(His jaw and tongue action were fine.)  It's difficult to describe her 
nipple-areolar complex - "inelastic" comes to mind.  Anyway, today baby is 
feeding beautifully, with deep latch with nipple shield and audible 
swallowing.  I feel that baby will do well without shield very soon.  In 
this case, I feel that without the shield mother and baby would have been 
very frustrated with possible nipple damage and staff would have given 
comps.

Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask] 

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