Laura,
Thank you for your response. It seems the issue is as complicated as I suspected! In my inexperienced view, I see the priority to be that the newborn is receiving breast milk, period. I can imagine much research is needed to determine how the potential interventions are prioritized for care. I would be interested to hear what your group determines from your research and wish you much luck!
Thanks again,
Janeane Calvert-Kuhn
Nursing Student
Ivy Tech Community College
----- Original Message -----
From: [log in to unmask]
Date: Tuesday, October 2, 2007 11:52
Subject: Re: nipple shields
To: [log in to unmask]
> Janeane,
> You have brought up some points that we (the group I work with)
> have been looking at recently. We have just requested a lit
> search to see what the latest studies reveal about nipple
> shields. Your personal experience with a shield ('a gift from
> God") is not unusual. We see women coming in to the hospital
> with nipple shields packed in their bags because a friend told
> them they should have it. Your reluctance to give it up is easy
> to understand. With significant nipple damage, there is
> significant pain. Since the shield relieved the pain, giving it
> up may mean the pain might return. What new mom wouldn't want to
> continue the use of the shield?
>
> I think that the bad reputation of nipple shields stems from the
> old shields that really did have a high incidence of low milk
> supply due to the materials the shields were composed of.?Some
> were made of thick rubber, some had a?glass base with a rubber
> nipple. The misuse & overuse are certainly concerns. Babies can
> have poor latch with a shield which can cause sore nipples &
> decreased milk supply.
>
> There are many opinions about the use of shields, re:?using at
> all or when to initiate their use. More studies?need to be done
> and case studies need to be published. Lactation consultants
> need more education about shields, how long to wait for babies
> to latch, ways to get babies latched and use of alternative
> feeding methods. Labor and birth practices need to be considered
> in the case of babies who don't latch and the how this should be
> handled. Do we use bottles, finger feeds, cups or?spoons to feed
> the breastfed baby who won't latch? If a baby will latch with a
> shield, is this preferred over having the mother pumping and
> using alternative feeding method? What, if any, are the legal
> issues with professionals recommending the use of shields?
>
> I certainly have a lot more questions than answers about the use
> of nipple shields. I do use them-many times they work well,
> sometimes they don't. Thanks for bringing up this topic. I'll be
> interested to see what others have to say.
>
> Laura Hart, BSN, RN, IBCLC
> Hospital-based in Winter Park, Florida
>
>
>
>
> I have been reading about the use of nipple shields and am
> amazed at the difference of opinion available in research. I was
> given one with my first son after having some significant nipple
> damage due to a poor
> latch. At the time, I felt it was a gift from God but my focus
> quickly turned to keeping this precious
> little thing safe and sound for the next feeding! My IBCLC
> insisted on short term use and although I
> kept it longer than she wished, I did relinquish it in time
> (more than three weeks!). There are reports
> that even the thin silicone nipple shields cause reduced milk
> intake and present a potential for reduced
> maternal milk supply and nipple damage with improper placement.
> Does their bad reputation perhaps have
> more to do with misuse than proper use--and proper use with the
> knowledge of potential risks?
> Is it more an issue of their wide availability and/or
> potentially untrained or inexperienced staff who
> cannot get an infant to latch on to the breast who may introduce
> them in the hospital to help the infant
> breastfeed before being discharged versus a simply good or bad
> label? Don't they have their place
> in the right situation (flat nipples, prematurity, etc.), with
> the close guidance of an experienced
> lactation expert?
>
> Thank you in advance for your patience and opinions on an old issue!
>
> Best wishes, Janeane Calvert-Kuhn
>
>
>
>
>
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