Nipple shields: What you need to know
There’s a lot of conflicting information about nipple shields. Here is a guide about when and how to use them.
Of all the breastfeeding accessories available on the market today, nipple shields are probably the most misunderstood. Many new mothers are sent home from the hospital with a nipple shield; often times these shields are handed out without proper instructions and are recommended when they aren’t even needed at all. Used incorrectly, nipple shields can interfere with a mother’s milk supply. However, when used wisely, they can be really beneficial. Here’s everything you need to know about nipple shields: what they are, when they’re warranted, and the advantages and disadvantages of using them.
What’s a nipple shield?
A nipple shield is an artificial nipple that is placed over the areola and nipple during a feeding. Nipple shields date back as far as the 16th century and have been made of materials such as rubber, latex, glass, metal, and even lead (yikes!). Today, they come in a variety of sizes (16-, 20-, and 24mm) and are made of soft, thin silicone. Some even have cutouts to allow the baby’s nose and chin to touch the mother’s breast.
When it’s appropriate
A nipple shield should never be the first intervention when a baby is having difficulty latching. Other techniques should be tried first and help from a lactation consultant may be all that’s needed to get a deep, comfortable latch. However, when there are obvious issues like prematurity or latching problems due to congenital conditions such as short tongue, tight frenulum, cleft palate, or low tone, a nipple shield may get the baby to breastfeed. In these cases, the nipple shield can help compensate for a weak suck and allow the baby to sustain suction onto the breast to successfully receive milk. Nipple shields can be beneficial for mothers who have flat or inverted nipples that have not responded to other efforts to improve the latch. A shield can also assist in the transition to direct breastfeeding when a baby has been bottle-fed and refuses the breast due to nipple preference.
Precautions to take
Some precautions need to be taken with a nipple shield, especially if it is used in the early days, before a full milk supply is established. Some mothers need to pump in addition to using a nipple shield in order to initiate and maintain milk production. It’s also important that baby’s weight, intake and output should be carefully monitored to ensure adequate milk transfer and weight gain. Of course, when not in use, nipple shields must be kept clean and protected in a shield case.
In general, a nipple shield should be in place for just a few minutes at the beginning of a feeding and then removed once the baby is nursing well. Once the mother removes the shield, she can quickly bring the baby back to her own nipple. However, some premature babies or those with congenital conditions may need the shield for the entire feeding. Each case is different and requires a tailored feeding plan to meet both mother’s and baby’s needs.
What’s the big deal?
One of the main concerns of using a nipple shield is that it is a barrier between the baby’s mouth and the mother’s breast, preventing the breast from being sufficiently stimulated to produce more milk. Additionally, a baby with a weak suck or congenital anomaly may need complementary feedings until milk transfer improves. Lastly, babies may develop a preference for the shield and have a hard time breastfeeding without it.
So just remember that nipple shields can be a valuable breastfeeding tool when all other techniques have been proven ineffective. However, they should always be used with caution and under the supervision of a lactation consultant to ensure proper use and ongoing assessment of the mother and baby.