Toni asked how to help a mom get off a nipple shield. I have never found trimming away a silicone shield to be effective. And, yes, any baby used to a shield is going to be mad when the shield is taken off--in his mind, you've just cut off the food supply. I teach moms to work backward. At the end of the feeding, when baby has got a full tummy, is relaxed and no longer frantic with hunger, remove the shield and try getting the baby back on. I tell her to be patient with the baby, and if it doesn't work the first time, don't worry--try again next feeding. With time, gradually work backwards. Remove it 3/4 of the way through the feeding, then half-way, etc. This has worked well for the moms I have worked with. There is no way to tell this mom how long it will take. There are babies that only need the shield for one feeding--others may need it days, weeks, or even months. I have worked with a number of women who used a nipple shield for 3 months or long--all had babies that were gaining well. Yet, all of them told me they felt guilty because everyone else was telling them they needed to get the baby off. I do explain that nipple shields have been shown to reduce "milk transfer." Understanding that concept, the mom is then aware that she may need to nurse a little longer than she would without the shield in order to get the same amount of milk into her baby. If she is also aware of signs of adequate intake (wet diapers, stools, etc.) then baby should do fine. Cher Sealy, RN, BSN, IBCLC