NIPPLE SHIELDS

WHAT IS A NIPPLE SHIELD

Nipple Shields are thin silicone devices that are placed over the nipple during breastfeeding. Lactation consultants will sometimes recommend nipple shields for people who are experiencing nipple pain, have flat or inverted nipples, or for premature or very small babies who are struggling to generate strong suction when on the breast. In the right hands they can be a useful tool.

Nipple shields can also be a double edged sword. We often see them being recommended without instructions, follow-up, or individual consideration. Nipple shields aren’t magic pills, able to solve all problems, but should be used as a set of training wheels in certain circumstances, with the aim of one day coming off of them. Some studies have found that nipple shields can decrease milk transfer and therefore decrease milk supply, while other similar studies found no decrease in milk supply. In practice, what we find is that success with a nipple shield comes down to getting the right fit. When it comes to sizing your nipple shield you will need to measure your nipple in a similar way to how you would measure for a breast pump flange (see our blog on Breast Pump Sizing). Get the diameter of the shaft of your nipple in millimeters and then have a look at the size recommendations on the packaging.

WHY USE A NIPPLE SHIELD

With the right fit, used sparingly and strategically, a nipple shield can be very helpful in establishing breastfeeding when a baby is reluctant to or is unable to latch on to the breast on their own. Other reasons may include:

A baby that has developed a breast aversion or a bottle preference.
A baby that has a tongue tie and you were waiting for an appointment or opting out of surgical treatment.
If there was nipple damage or pain when breastfeeding and the mother was struggling to continue. The shields can give the nipples a break, protecting the skin and allow time for the tissue to heal until we can resolve the issue that caused the damage in the first place.
Premature or smaller babies; nipple shields can help to generate a stronger suction on the breast, creating better milk transfer.

Nipple shields are best used temporarily and with a plan to wean the baby off as soon as it's reasonably possible. Some babies will use shields for a few days, or even just a few feeds, while some might need it for as long as a couple of weeks to a few months. I've even known some women who've breastfed their babies entirely with nipple shields for years. All of this is ok because ultimately if it works it works! At the end of the day the baby's feeding on the breast and that's a win in my book. We can always work on coming off the shields later.

HOW TO USE A NIPPLE SHIELD

One common mistake that we see is using a nipple shield in the first 3 days after the birth, while you’re waiting for your milk to come in. During this transition time your body makes colostrum, which is slightly more thick and viscous than mature milk. This thicker liquid makes it more difficult for the baby to feed through the shield, making them frustrated or even sleepy on the breast. Don't fall into this trap. Wait until day 3 or 4 to try with the shield.

To apply the shield, wet the inside of the wings with some water or expressed breast milk and then place over the breast with the nipple central in the shield. You'll find that most nipple shields have a flattened side or divot in them. This has been designed for your baby’s nose to rest in, so that it will be flush against your skin. Line up the flat side or divot, depending on the position you plan to use, so that the nose will be in the right spot. Now baby can smell you and experience the normal sensations of breastfeeding without completely masking this with the shields.

Once the nipple shield is applied, you’ll latch the baby to the breast in the exact same way as you would latch without the shield. See our other blog posts on achieving the best latch. Check and make sure that milk transfer is occurring. Look for pooled milk inside the nipple shield and or milk inside baby's mouth and listen to audible swallows when suckling. Also, check and make sure that your breast feels soft, empty and drained after each feed.

HOW DO I STOP USING A NIPPLE SHIELD

Once you have established feeding with the nipple shields, look for signs of readiness in your baby to start weaning off of them. You’ll know they might be ready when they can confidently latch and feed with them in place, milk supply is established and there is good weight gain and frequent dirty diapers. When you are ready to try, first offer the naked breast without the shields and see if they're able to latch on their own. If they still struggle or you're still experiencing pain, try starting the feed off with the shield, wait for a natural pause in the feeding, and then remove the shield to latch the baby again halfway through.

Babies learn how to breastfeed through the tactile sensation of having the breast in their mouth. So each successful feed without a shield will help to teach the baby how to latch again the next time. Slow and steady. With patience and perseverance, you can teach them to step away from the nipple shields.

We find these Medela and Mam nipple shields have the best reviews and most success!