Nipple Shields - the good, the bad & the risky
Updated: Jun 16
What is a nipple shield?
It is a soft, thin, silicone, nipple-shaped barrier that goes over the parent's nipple allowing the infant to latch without touching skin on skin. If using or considering using a nipple shield, make sure to continue follow-up with us (or another IBCLC) to ensure no issues arise and we are still working on the issues/goals at hand.
What are nipple shields used for?
Nipple shields are a temporary tool we can use when severe issues arise. This may include difficulty latching, re-introducing breastfeeding after long term or intensive bottle feeding, and/or severe pain or nipple damage.
****Nipple shields will not help the underlying issue(s) causing whatever problem you may be experiencing, but it can help us as we work towards our goals.****
Risks & benefits with nipple shields:
Using a nipple shield can literally save a breastfeeding relationship and has on more than one occasion! But just as often as it helps, it can also hinder when not used for an appropriate reason or used correctly. There is always a risk and benefit to any action or lack of action, so here is a quick summary:
Can help prevent or decrease nipple pain and/or damage when used appropriately.
Can allow nipples time to heal while still breastfeeding your baby.
Can aid in obtaining deeper latch and removing more milk from the breast.
Can help slow an overactive milk ejection reflex and allow infant to feed without sputtering or choking if applicable.
Can aid in latching premie infants
Can help infants transition from feeding via bottle to the breast
High risk of drop in milk supply if not pumping after every use. Not the same hormonal response from parent as when latching skin-on-skin
Since it is a barrier, it can limit amount of milk removed from the breast which can reduce milk supply
The longer it is used, the higher the risk of drop in milk supply and difficulty weaning from shield
Weaning from nipple shield can be a long and sometimes tricky process
Due to decrease in milk transfer, there is an increased risk for mastitis and plugged ducts
It may be more difficult to feed at night or in public when relying on a shield.
Start by pushing the nipple part of the shield slightly in, like it's halfway inside out
Press the inside out part to your nipple and then press it against your skin. As it seals against your nipple, the vacuum should help your nipple "pop out" with the shield sort of holding it, molding it in place.
Try to express a few drops into the tip of the shield if you are able. Sometimes this is tricky while keeping the shield in place. You can also place a small amount of nipple cream around the base of the shield to help it stick a little better.
When ready to attempt to latch, "sandwich" your breast in a "U" shape in the direction of the baby's mouth. (If your baby is feeding across your body like cradle or cross cradle, your "U" should look like a typical "U" shape. If your baby is feeding in football or more laidback, your "U" may need to be more of a "C" to conform to the direction of the baby's mouth.
Then commence how you normally would latch deeply: Bring baby nose to nipple at breast level, make sure their head, shoulders and hips are all in line. When they open their mouth, bring them quickly towards the breast "folding" the breast tissue into their mouth at the same time. (Check out our Positioning & Latching resource for a full run down on this!)
Your baby should be latched deeply onto the breast/nipple shield, lips going to the base of the shield, not just the tip. You should hear swallowing and feel/see a rhythmic suck/swallow pattern.
Pump after each time you utilize a nipple shield for maximizing milk removal and to avoid any possible risks of lowering milk supply.
Watch diaper count very closely to make sure your baby is transferring the amount of milk they need based on their age.
Don't forget to continuing follow-up with your IBCLC!