About that Nipple Shield.....

Every time I see a nipple shield I flash back to my own experience breastfeeding my first baby. On my second day postpartum, a kind-hearted Lactation Consultant took a look at my chest and winced. She applied a nipple shield to my breast and told me this might help with the pain (because, eek....all the cracks, bruises, and bleeding sure weren't helping with that!). Looking back, I just know I would not have kept breastfeeding one more day without her help! My nearly ten pound baby was losing "an excessive amount of weight" and, according to one of my nurses, I was "headed for trouble". Gosh....Thanks for the pep talk, Honey.

Nipple shields come in many shapes, sizes, and styles, and are indicated for "latching difficulties". In the Lactation world, starting a discussion about nipple shields is about the same as discussing presidential candidates or gun control at your workplace. Emotions escalate quickly!

Speaking from experience, nipple shields can be helpful in MANY situations. Does every mom need a nipple shield to help baby latch? NO! But for women with flat or inverted nipples, women who have traumatic surgical births, trans parents, or in cases of extreme nipple sensitivity, they can help breastfeeding BEGIN. In addition, I have personally helped moms use nipple shields to facilitate latching newborns with oral tethers, very small mouths, tendency to tongue thrust, preemies with a weak suck reflex, and in some cases where an SNS feeding system was in use to supplement baby at breast.

As far as evidence-based practice recommendation goes, some old studies from the 1990s found that nipple shields were associated with low milk supply and inadequate milk transfer from the breast. YIKES!!! That sounds like a good way to get some Lactation Consultants flustered! Fast forward a couple of decades and more recent studies find that the correlation may not be so direct. Recent research offers a better explanation. While moms who use nipple shields may struggle to achieve a deep latch, the LATCH is more likely the catalyst that can have such a major impact on mom's milk supply (and, in turn, on how much milk baby transfers at breast). Some studies found that, for moms who used nipple shields in cases where baby was unable to obtain a deep latch without one, milk transfer was INCREASED for baby. That being said, nipple shield or not......baby is unlikely to transfer an adequate amount of milk from mom's breast in the absence of a DEEP LATCH.

Do I encourage my clients using nipple shields to try and wean baby off of using a nipple shield? Yes! I encourage them to do so as soon as mom is able to latch baby EFFECTIVELY without use of the nipple shield. For some, this happens quickly. For others (like me), it can take months (or never happen). And that is 100% OK! Do I believe in a cookie cutter approach to caring for families using a nipple shield? ABSOLUTELY NOT! What I do believe is that every breastfeeding family, especially those using a nipple shield, should seek professional guidance from a Board Certified Lactation Consultant in order to ensure the best breastfeeding experience possible!