using nipple shields correctly

A nipple shield, breast shield or nipple guard is a thin, flexible cover usually made from silicone and designed to assist mothers and babies who are experiencing latching difficulties.

There is much controversy when it comes to using nipple shields, this is because it isn’t yet clear how effective nipple shields are in the long run. In addition to this, most breast-feeding problems can be corrected without the use of a shield and all options should be thoroughly explored before using these devices. Nipple shields can contribute to nipple confusion especially if one is using a baby bottle for top ups.

However, when used correctly and under the care of an experienced lactation consultant, I have seen countless feeding sessions turn from stress to bliss with the use of nipple shields.  They can honestly make or break your breastfeeding voyage and at the end of the day, it is better to have a baby on the breast with a shield than not on the breast at all.

shield

For some woman, they will only ever be able to breastfeed with the use of a shield while for others it is just a temporary solution. There are many different reasons for your Lactation Consultant to recommend the use of a nipple shield. It could be due to flat, short, inverted nipples or breast refusal. Babies with a tongue tie will generally feed better off a shield or if the mother is experiencing severe nipple trauma a shield will create a barrier which can reduce the pain. When using a nipple shield as a temporary solution such as cracked or bleeding nipples, one should only use them for up to ten days. Any longer than this and your baby will most likely struggle to wean off of the shield.

Some disadvantages of using nipple shields include:

if used incorrectly, your baby may battle to extract a sufficient amount of milk which may in turn lead to plugged ducts, mastitis and an insufficient milk supply

the use of nipple shields can slow down the flow of milk which means that feeds may take longer than they did / would without a shield

if not properly washed and sterilised, shields can act as a breeding ground for thrush

it can be extremely difficult for baby to wean from a shield if used inappropriately or for very lengthy periods

Choosing a nipple shield

Shields come in various shapes and forms. Silicone is better than latex as it is thinner and more pliable which makes for easier milk extraction. Contact is better than regular as these have a section which has been cut out allowing more skin-to-skin contact while baby is feeding.

Shields come in various sizes too. Most women will do well with a regular / medium / 24mm, shelf bought shield. A shield which is too small can decrease milk supply and cause unnecessary discomfort or irritation.

Using a shield correctly

Make sure that your shield is washed and sterilised, but dry before use

Use a little hand expression to encourage milk flow and to evert the nipple

Stretch the shield slightly while placing it over the breast – this will allow it to stick nicely and to stay in place

Make sure that the top of the shield is placed where your baby’s nose will be during the feed, in other words, make sure that your baby’s nose will be touching your skin and not the silicone of the shield.

Latch your baby exactly as you would without a shield, making sure that his lips flange outward and that he takes in as much of the breast as possible. This will aid in milk extraction which in turn will help to keep your milk supply up.

Continue to feed your baby as you normally would, learning to read your baby’s feeding cues and allowing him to finish the feed when he is full.

Remember to wash and sterilise your shields after each use. Doing this at the end of each feed and storing them in a sterile box will ensure that they are dry and ready for your next feed.

Always use your shields for as LITTLE time as possible

Weaning off the shield

Remember that this is WEANING, so it is generally done gradually and when your baby is in a happy space. I usually suggest that a mother start the feed with the shield, this will help your nipple to evert as well as give your baby a nice easy ‘starter’ which will eliminate crying and frustration caused by hunger.

Never let weaning become stressful, if it doesn’t work go back to using the shield and try again at the next feed – remember that it is always better to have a baby latched on with a shield than not latched on at all.

Get help if things become stressful and always try to use breastfeeding devices under the care of a qualified Lactation Consultant.

Article by breastfeeding consultant Jenna Richards