I have a love-hate relationship with nipple shields. I love them because they enabled my daughter to latch on in the beginning of our nursing relationship when she might not have otherwise. I hate them because I think they are given out too easily, and without warning the mother about the repercussions of using them.
What they are
A nipple shield is a thin piece of silicone that is placed over the mother's nipple during a feeding. They look a bit like a bottle nipple, but are much thinner and have a wider, thin, flat base.
Why they are used
Nipple shields are used 1) when a baby is having problems latching on due to flat or inverted nipples, 2) when a baby has a very small mouth and the mother has large nipples in comparison (often the case with premature infants) 3) extreme overactive letdown 4) extremely sore, cracked, or bleeding nipples.
Why they can help
Because the shield covers the nipple and areola, it makes it quite difficult to have a bad latch. There really is only one way the baby can suck on the shield. A baby that is having difficultly latching onto a flat nipple can easily latch onto a shield. It can also help a preemie effectively get milk from the breast. Nipple shields reduce milk transfer. The milk has to first collect in the shield before it pours out, so that can help with overactive letdown.
The downsides of using nipple shields
It has been said that nipple shields can cause low milk supply. However, new research has shown that is untrue with today's nipple shields.
Also, nipple shields are inconvenient. Because of a reduced milk transfer, nipple shields increase your risk of getting plugged ducts and mastitis. While it is not definite that they will cause a low milk supply, as a Lactation Consultant I was going to said, "I'd rather not take the risk."
What to do if you are using nipple shields
Make sure you see a Lactation Consultant, the sooner the better. By 12 weeks post partum your prolactin levels go down, and milk production is no longer hormonally based. This is a common time when women's bodies no longer compensate for whatever nursing problems you may have. Your supply can start to plummet around that time. So, it is very important to work on weaning off the shields. Try latching the baby onto the shield first. Then, after a minute or two, take the shield off, and quickly latch the baby to the bare breast.
The LLL actually states that, if you cannot get the baby to latch on to the breast, it is ok to use nipple shields for the entire nursing experience. I personally think that sounds awful!
To get a shield to stay on properly, it is best to flip it halfway inside out, get it wet with water, and then flip it right side out while on your breast. That way, it draws the nipple into it and stays on better.
Also, keep your shields clean. They need to be washed with soap and water after every use. What I used to do is fill up a glass with hot soapy water and use a bottle brush cleaner to scrub the shields.
Never forget that your baby *will* latch on without the shields. I have completely flat nipples, and used shields exclusively for the first six weeks of my baby's life. I started weaning at six weeks and was not fully finished weaning off them until 12 weeks (although I was only using them at night by 10 weeks). Keep a positive attitude, and you will succeed in weaning off shields. If I did it, so can you.
Moms who have used nipple shields and been sucessful weaning from them: