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Ins and Outs of Nipple Shields

Suction Is Key

For an infant to breastfeed successfully, suction is key. Babies rely on suction to transfer milk from the breast. Research indicates that the latex and rubber nipple shields can drastically reduce milk intake because there is just insufficient compression on the milk sinuses in the breast for adequate milk to reach the baby. Even the thin silicone nipple shields, which are the most common type in use today, can potentially reduce milk intake if they are not placed on the nipple correctly.

Why Bother?

There are times in which a nipple shield becomes a necessity. Some of the most common reasons healthcare providers or lactation specialists recommend them include:
  • Aiding premature infants who are physically not able to nurse
  • Improving the baby's ability to latch on when the mother has flat or inverted nipples
  • Overcoming latch-on problems caused by engorgement
  • Assisting when infants have "nipple confusion" and they prefer an artificial nipple to the mother's breast
  • Overcoming breast refusal
  • Protecting or preventing sore, chapped, or cracked nipples.

Use Nipple Shields Wisely

In many ways, nipple shields are merely Band-Aids. They may help a situation temporarily, but don't fix the underlying cause of the problem. Here is where the phrase "use nipple shields wisely" comes into play. This is also where it can help to have a good teacher, someone who has experience in getting the best latch-on position for your individual needs, and someone who can be there in person with you to ensure you are breastfeeding as effectively as possible.
There are times when there is no other option than to use a nipple shield. Knowing when they can help and knowing when they are being misused are important factors to consider. In many cases, the use of a nipple shield can be avoided. For instance, proper latch-on techniques can help prevent nipples from becoming sore. If your nipples aren't sore, using a nipple shield to protect them is unnecessary.
Also, knowing how to prevent engorgement can make it unnecessary to use a nipple shield. If engorgement does occur, you can simply express some of the milk to make it easier for your baby to latch on.
For these types of cases, nipple shields do not treat the cause of the problem. Whenever possible, try to solve the problem first by improving breast care and breastfeeding techniques. In many cases, just making minor adjustments to your daily routine and taking time to learn some helpful tips can make a nipple shield unnecessary.
However, research has shown that there are some situations in which nipple shields do help preserve breastfeeding. One study showed that preterm infants who kept falling off the nipple during pauses in breastfeeding would nurse more effectively and were able to drink more milk when a nipple shield was used. They were also able to stay awake longer and would nurse for longer periods. The infants in this study used the nipple shields for varying amounts of time, with a mean of 32.5 days.
Also, women who have flat or inverted nipples and are unable to use some standard techniques may benefit from nipple shields. There may also be cases where a baby has high muscle tone or is tongue-tied. The nipple shield can help to push the breast past the humped tongue to help activate suckling.
There may be times when you feel you have tried everything and you are getting nowhere. If this happens, using a nipple shield (whether the research says it's right or not) may help to relieve your feelings of stress.
Breastfeeding, even with minimal problems, can be a stressful time for many mothers. If using a nipple shield every once in a while helps to bring some relief during those "maxed-out moments" where your breasts are sore or you just can't get a good latch, go easy on yourself. The world is not going to end if you have to use a nipple shield in some situations. Again, just remember to use it wisely.
(Click Breast Care While Nursing for more information on how simple breast-care tips can help you avoid the use of a nipple shield. It also explains how to treat an underlying problem that may cause sore and painful breasts.)
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