I sent a response to a similar question a couple of months ago that never did show up on my digests, (if it showed up on yours I apologize for being redundant) so I'll send it again: <<Now, another question--what do you think about nipple shields? Anybody out there using them? Are they anathema, or are they helpful in a few, carefully selected cases? We haven't been using them, but my colleague has suggested we get a few and keep them under lock and key, so that the staff nurses don't fall into the habit of solving every problem with a shield. I'm willing to reconsider, if anyone has had success with them. Judy D.>> I wanted to add my 2 cents because I'm one of those people who "grew up" in lactation believing nipple shields were the work of the devil. I'm an old LLL Leader, and heard all the horror stories about trying to wean babies off of them and the dangers of decreasing milk supply. I now use them very judiciously and they have sometimes saved situations in which I am certain the mother would have otherwise weaned. It is my impression that all the studies that showed decreased milk supply with shields were done with the old latex shields, not the currently available silicone ones. I suspect that a mother with a marginal milk supply could be compromised when using a silicone shield, so I'm pretty careful with follow-up, but I have not seen a problem. I'm hospital-based, so deal with a lot of marginally-motivated mothers. If baby isn't on the breast within a few days, that's it. When they work, I think a shield has distinct advantages in that feeding is a one-step process instead of a two-step (pumping + feeding), and baby is feeding *at* the breast. The shields are out of sight in my office, and I think after all this time many of the nurses don't even know I have them. I probably only use about 20 a year. A couple of situations I can think of: 1) Worked with a mother shortly before discharge whose baby was doing pretty well latching on with just a bit of help from the nurses, but mother was absolutely unable to latch baby on by herself. Definitely one of the klutziest moms I have ever seen at handling a baby. Tried every which way I could think of to position them, enlisted dad's help, but no luck. With a shield mom was able to get the nipple in the mouth, baby did the rest. Saw them back 2 days later, mom was getting much better at handling baby, we worked on technique without the shield, they went home and did just fine without it. 2) Consult for a mom & baby who had delivered elsewhere, about 2 weeks old, had seen several "consultants" at that hospital, had been sold every gadget Medela makes *except* a nipple shield. Came to see me as a last resort before weaning. Baby would open well, latch on, but bring the back of the tongue up as she started sucking and lose the nipple. (Now, had I seen her initially I would probably have tried some of the suck-training exercises first, but she had already "tried suck-training" with the other people.) With a shield baby did not lose the nipple when she sucked; due to its firmness it stayed in position in her mouth. Mom was thrilled at being able to stop pumping and fooling around with all kinds of stuff. Milk supply stayed fine, weight gain was fine, mom & baby came to our support group for months so I saw them regularly. Baby was about 3 months old when she was able to nurse consistently without the shield. Enough raving. I vote for judicious use in selected situations. Becky Krumwiede, RN, IBCLC [log in to unmask] [log in to unmask]