You hear lots of different opinions about nipple shields, we give you the most recent research how how to best use them.
Using a nipple shield when breastfeeding
You will hear a lot of opinions about nipple shields! ‘Don’t ever use a nipple shield or you wont have enough milk’ all the way to ‘I used them for months and had no problem, use them as soon as you have any problems’, and everything in-between!
Opinions tend not to be based on evidence based information. So here you are, reading about using nipple shields when you are breastfeeding, perhaps wondering if they are good or bad or somewhere in between! Perhaps you are pregnant and you have heard others say they are a ‘must have’ product.
For some, breastfeeding with a nipple shield can be a useful tool and a temporary measure whilst you look for further skilled support. In my experience most will start to use a nipple shield because they are experiencing pain and damage to their nipples and, given after all “your nipples DO matter”, a shield offers relief for some. But this is a ‘plaster’ on the root issue, we should be offering breastfeeding support from the get go that helps to overcome common challenges like pain and nipple damage, and if that person can’t to refer up to the next level of a support.
As such, it is important to work with a skilled breastfeeding supporter such as an IBCLC Lactation Consultant if you are considering using a nipple shield, as it can have some drawbacks.
Whilst a nipple shield might be helpful in reducing nipple pain and can provide extra protection for sore or cracked nipples. , it can also reduce milk transfer, so it is important to make sure the shield is the right size for you, that your milk supply is protected during its use and you get support to help you transition away from them if possible.
It’s important to remember that a nipple shield is a tool in an IBCLCs ‘toolbox’ and is used in certain situations with success, for example flat nipples, some premature babies, or when waiting for a tongue tie division.
What is a nipple shield?
They are thin, silicone shields that fit over the nipple and protect it from the baby’s suction. There are a variety of different types and sizes of shields to choose from, so it’s important to find the right one. Some will have cut outs for the nose and chin, others will have only one cut out for the nose, some prefer to put the cut out where baby’s chin is as that is what does the work to remove milk on a well attached baby.
Regardless of the type you get, be sure to get the right size for your nipples and follow the instructions for proper use and cleaning.
Choosing a nipple shield?
It’s important to choose the correct size shield for your nipple. If the shield is too small, it won’t provide adequate protection, and if it’s too big, it may cause discomfort.
Cleaning your nipple shield?
It’s important to make sure to clean your nipple shield after each use and keep it clean between uses, they often come with a little storage case. For a healthy term baby you may choose to sterilise once a day and then use hot soapy water to clean the shields between feeds.
Applying a nipple shield
It might seem sensible to just ‘plonk’ them on top of the nipple, but to CORRECTLY apply them you must turn the tip almost inside out, then apply by rolling onto the nipple. A well fitted nipple shield is vital to help milk transfer.
Latching with a nipple shield
It’s often easy to let baby ‘slurp’ the nipple in and attach centrally but it’s still vital that you work on ensuring a deep latch with correct positioning and attachment, to enable effective and efficient milk transfer.
As shields form a barrier between breast and baby it can make it a little harder for the baby to have effective and efficient milk transfer.
To offset this it is can be helpful to use breast compressions after baby stops actively drinking to help encourage a bit more milk removal.
Seek support when using a nipple shield.
The majority of nipple pain and damage will be as a result of a shallow latch and some good support with positioning and attachment can help quickly address the pain and damage and shields are no longer needed. Where there is more going on than just needing to correct positioning and attachment then support is needed to help work you understand what is happening and support you on your breastfeeding journey.
You can ask for support from your midwife, health visitor, peer supporter, breastfeeding counsellor and IBCLC Lactation Consultant.
So, KEEP ON SEEKING SUPPORT. Pain is not normal, no matter how ‘good’ you’ve been told that latch might be.
