Koren Welcome out of lurkdom. Good observations and questions on shields. Just to give some perspective on when shields are really useful. I do not have shields at the hospital where I work. There have been only a handful of times in about 4 yrs when I felt I could have really used one. In those cases I have one as a sample and show/explain to mom and suggest it may help and they can purchase one. I can then do an office consult on how to use. These cases are usually for inverted nipples. We have decided to order some shields (don't have them yet) but only my personal cart will carry them. The nurses will not be able to give them out. These are the things that usually help tremendously and make shields unnecessary in most cases: Initiate breastfeeding w/i 1 hr of birth. Practice skin to skin care and rooming-in. Show the mother how to position the baby in cross-cradle, cradle and football holds (at least one of these) so baby can access the nipple/areola ideally and latch. Learn and use RPS (reverse pressure softening) which works to evert flat nipples, start an MER, and move edema out of the way to make the nipple-areolar complex quite latchable in most cases. Begin expressing colostrum early and spoonfeed to baby if he's not able to latch. Often the next day the baby does latch. I think the nursing staff get very nervous when the baby does not latch and grab for a quick fix. Often the baby has not fed and is not gotten to his mommy for many hours and they begin to panic a little. Nurses need more skills at assisting bf moms and of course implementation of baby friendly practices. Easier said than done. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html