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Nipple Shields for Breast-Feeding Problems

Topic Overview

What are nipple shields?

Nipple shields are devices to help with certain breast-feeding problems. A nipple shield looks like a little hat with a brim. The crown of the hat fits over the nipple, and the brim lies over the areola. Most nipple shields are made of a soft, thin, flexible plastic.

Why might nipple shields be used?

Nipple shields may be helpful for babies who have trouble sucking, such as:

Premature babies may not have strong suction and may not be able to latch on as well as full-term babies. Suction is important because it helps the baby get enough of the nipple in his or her mouth. Nipple shields can help premature babies get a better latch and get enough milk.

Nipple shields are meant for short-term use. For example, they might be used with a premature baby until the baby's expected birth date. So for a baby born at a gestational age of 35 weeks, you might use nipple shields for a few weeks. After that, the baby will probably be able to nurse without a shield.

What should you do if you think you need to use nipple shields?

Nipple shields look simple, but there are some tricks to using them correctly. So be sure you get guidance from a lactation consultant or other breast-feeding expert. Your hospital, doctor, or midwife can help you find an expert in your area.

A lactation consultant can:

  • Fit you with a shield that's the right size and shape.
  • Help you make sure that your baby is latching on and feeding properly.
  • Advise you on how long to use nipple shields.
  • Offer tips on how to wean your baby from the shields when the time comes.

How will you know if you are using a nipple shield correctly?

It's important to use a nipple shield correctly. If it isn't used the right way, your nipples could be damaged or your baby may not get enough milk.

These signs mean you are using the shield correctly:

  • You feel your milk let down.
  • You can see milk in the shield and hear your baby swallowing.
  • Your baby is making a good latch.
  • It doesn't hurt or pinch when your baby sucks.
  • The shield isn't puckered or dented when your baby is latched.
  • Your baby is gaining weight as expected and has the expected number of wet and dirty diapers.

When should nipple shields not be used?

Experts say nipple shields should not be used:

  • To treat latch-on problems in full-term babies.
  • To prevent or manage sore or cracked nipples.
  • When a mother has flat or inverted nipples.

In these cases, it's better to deal with what's causing the problem than to use nipple shields. A doctor, nurse, lactation consultant, or other expert can help resolve these issues.

Experts have concerns about the use of nipple shields in full-term babies.

  • Nipple shields slow the flow of milk, so feedings take longer. A full-term baby may not get enough milk. Plus, if the breast isn't emptied, the baby will miss out on some of the hindmilk, which is rich in calories and nutrients.
  • Using the shields may reduce milk supply. Nursing stimulates the release of hormones that keep up the milk supply. But the breast isn't stimulated the same way when a nipple shield is in place.
  • It can be hard to wean a baby off nipple shields. It takes less effort to get milk through an artificial nipple, so a baby may refuse the real nipple when it's offered. This may make breast-feeding more challenging.

In general, experts think nipple shields should be used only if other possible solutions were tried and didn't work.

References

Other Works Consulted

  • Academy of Breastfeeding Medicine (Revision 2010). ABM Protocol #7: Model Breastfeeding Policy. Breastfeeding Medicine, 5(4): 173–175.

Credits

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Last Revised July 3, 2013

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