To Shield or Not to Shield
The many uses today of the nipple shield and its easy availability online and in big box stores has led to the misunderstanding and misuse of the nipple shield and its role. Stigma against its use due to incorrect ideas of the shield’s purpose have mothers struggling between benefit and supposed risks of the shield. Care providers and lactation supporters should make sure proper education is provided on the reasons for and proper use of the nipple shield.
The nipple shield uses focus on providing missing components in breastfeeding, enabling breastfeeding and proper milk transfer to occur. The shield helps to provide a nipple shape in the infant’s mouth, supplying oral stimulation that could be lacking from mother’s own nipples. It helps to compensate for weak infant suction and allows for the extraction of milk by expression with minimal suction and negative pressure. It helps with nipple shape, maintaining position in baby’s mouth between sucking bursts and keeps nipple in a protruded position (Walker, 452).
The use of a nipple shield should not be the only step in improvement of the breastfeeding dynamic. (Walker, 452) Instead an evaluation of the whole breastfeeding process should be made. If milk transfer or pain are due to true low milk supply, incorrect latching or tongue tie; the shield is not an effective replacement for proper interventions for these needs. Thus self-diagnosis for the use of the shield is not suggested. Instead a consultation by a certified lactation professional is ideal to determine actual need for a nipple shield.
There are disadvantages of using the nipple shield, especially if used for the wrong purpose or with improper technique. According to Kelly Bonyata, IBCLC, “nipple shields should in general be considered a short-term solution and should be used under the guidance of a lactation consultant.” But this does not mean that all mothers should stop using the shield at a set measure of time. Every baby is unique in its needs. If every effort to correct underlying issues have been made and baby is gaining well with the shield, there is no time frame limit on its usage. “There is no set time for weaning; extended use of the ultrathin silicon shield has not been shown to be detrimental” (Walker, 452)
Weight checks should be done in early usage to ensure efficient milk transfer is occurring. Once baby is gaining well with use of the shield, frequent weight checks are not needed. “The thicker rubber nipple shields available some years ago were found to reduce supply and alter babies sucking patterns, but many have found that in certain situations the new thinner flexible silicone nipple shields can help a baby successfully transition to the breast” (Mohrbacher and Stock, 112).
Sometimes mothers find their infant needs time to grow so their mouths are larger to accommodate the breast. “Regular offerings of the breast without the shield will help capture the time where baby is able to maintain the breast in the mouth without support” (Eglash et.al.). While there is not one specific way to promote weaning, a variety of options to try are available to the mother. The mother can start the feeding with the nipple shield. Once baby has moved past its initial hunger, the shield can be quickly slid off so baby can re-latch.
While there are some known disadvantages to the use of a nipple shield, it can be very effective at providing solutions that left untreated would most likely lead to premature weaning. The key to its success is to using the nipple shield for the appropriate reasons under the direction of a lactation specialist, while also pursuing correction of the underlying reasons for the use of the shield. While the shield can be used for an extended period of time, regular offerings of the breast without the shield will keep baby familiar with the feel of the breast and also catch earlier the time baby is ready to return to the breast. The shield is a useful tool to maintain breastfeeding; but as with all tools is best used for its intended purpose and not abused through unnecessary interventions.
Leah Garner CD and PCD is a certified birth and postpartum doula. A mother of three children, Leah has extended experience with nursing her own children. In addition she is also active in her local La Leche League chapter and helps to co-lead the hospital breastfeeding support group. She enjoys spending time with her family in nature and reading a good book in those rare free moments of motherhood.
Bonyata, Kelly, BS, IBCLC. “Nipple Shields • KellyMom.com.” KellyMom.com. N.P., 07 Jan. 2017. Web. 12 Apr. 2017.
Eglash, A., A. L. Ziemer, and A. Chevalier. “Health Professionals’ Attitudes and Use of Nipple Shields for Breastfeeding Women.” Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine. U.S. National Library of Medicine, Aug. 2010. Web. 12 Apr. 2017
Huggins, Kathleen. The Nursing Mother’s Companion. 4th ed., Boston, MA, The Harvard Common Press, 1999.
Mohrbacher, Nancy, and Julie Stock. La Leche League International: the Breastfeeding Answer Book. 3rd ed., United States, MATTHEWS Book CO (MO), 2003.
Walker, Marsha, et al. “Breast Pumps and Other Technologies.” Breastfeeding and Human Lactation, 5th ed., Jones & Bartlett Learning, Burlington, MA, 2016, pp. 419–468.
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