Hi, y'all, Very timidly I wish to say that since reading here on our wonderful Lactnet forum the tips from the ILCA Cnf in Kansas City that I have had to eat my words and try a nipple shield. I'm the one who used the nipple of the old rubber ones as a nose to draw a frowny face to show at inservices and bf classes.....yeek!. Dr. Jack, I hope you know how much courage it's taking to write something that seems to contradict you. Gulp. I think we ought to play the darned things like a kazoo and let a panel of judges decide...at 10 paces. Barbara, maybe we can share a caldron of hot water? First time, the mom had been sent home from a rural hospital with a *rubber*--the hard kind!--nipple shield and she got teary eyed when she tried a silicone one a generous pump rep had given me "in case it would ever come in handy" this mom was so amazed at the difference, and stretching the darned thing to slurp in her nipple (professional terms, huh?) made it stay on all by itself. The mom was so danged pleased with the thing it was *weeks* before she wanted to try going without--whipped it off in the middle of the active swallowing following a MER and baby latched back on and that was that for the ole nipple shield. I truly believe this dyad would not be bf today without using one. Other case(so far) was a 15 year old mom whom I saw in the hospital on the day of the birth..she'd had every intervention known, and a few they invented just for her, and her nipples, huge anyway, and areola were so swollen (yes, stadol was used) the baby's mouth didn't have a hope. This mom was shaky, whiny and *in pain* from a section and still on IV for antibiotics-"why? Because."--, so I didn't see the edema resolving anytime soon. After a 90 min visit (unpaid--she's medicaid) I pulled out a normal sized nipple shield (wasn't sure it'd fit, but that inside-out-rim-and-stretch-technique surprised even me) and voila. Used it for 5 days. Again, I doubt that this mom would have endured--NOT at all interested in pumping to maintain supply. Just a make-it-work-*now*-or-we-can-use-the-bottle attitude. Now, I haven't changed my attitude about nipple shields in general--they're a dangerous quick-fix in the hands of a non-expert. As a last resort with someone who is willing to do intensive follow-up, they could save a breastfeeding relationship. And yes, I have a consent form for their use I have the mother sign. And I'm humbly learning never to say never.... Karen Zeretzke, MEd, IBCLC Baton Rouge, Louisiana