As I’ve stated many times to anyone who will listen,  nipple shields can be helpful if a baby is having trouble breastfeeding. In the wrong hands, however, they can be downright dangerous. Just today I saw 2 moms who were given nipple shields in the hospital within 48 hours of their babies’ birth.  Their 2 stories had very different outcomes.

Story number 1:  Three -week- old baby. Mom given nipple shield day 2 because baby was having a hard time latching. Baby was able to latch with the shield, but he nursed for 45 minutes to an hour each feeding and never seemed satisfied. Things seemed to go OK the first week, but at a routine check-up 2 weeks later, baby hadn’t gained any weight. The pediatrician told mom to start supplementing immediately and referred her to me. I saw her the next day.

After a little guidance, baby latched on to the breast easily and nursed well. Mom’s milk supply is very low, of course, since baby was not transferring milk well with the nipple shield. Now this mom has quite a bit of work ahead to increase her milk supply. In the meantime, this baby will need to be supplemented with donor milk or formula.

Story number 2:  Three- day- old baby. Mom was given a nipple shield after the very first attempt at breastfeeding because her baby’s latch was incorrect and her nipple felt pinched. Fortunately, this mom had arranged to see me prior to her son’s birth and I consulted with her in her home.   The baby latched easily after I showed his mom how to help him find the breast. He breastfed happily while his parents watched in awe—surprised that he could do so well without the nipple shield. Mom was absolutely comfortable and delighted that breastfeeding did not hurt!

Story number 2 turned out well. It likely would have had a very different ending, however, if this mom had continued to use the nipple shield.

The lactation consultants or nurses who dispensed the nipple shields (2 different hospitals, by the way!) did not attempt to correct the underlying problem BEFORE resorting to plastic.  In addition, they did not teach the moms how to assess the babies’ effectiveness using the shield while breastfeeding. Finally, there was no follow -up offered or suggested to ensure that either of the babies were transferring enough milk to gain weight.  I’m not saying that the hospital staff is unskilled or don’t care about mother and babies.  I AM saying that hospital protocols and time constraints don’t allow for thorough evaluation.

I wish these 2 stories were isolated incidences. They are not. I see more or less the same scenario several times a week. So how can you avoid this very common problem?

• Know that your baby was born to breastfeed!
• Avoid nipple shields in the first 24 hours.
• If you’re having trouble breastfeeding, insist on getting help. If the hospital cannot provide you with timely, knowledgeable, REAL help, ask a nurse for a referral to a private lactation consultant.
• If you decide to use a nipple shield, make sure someone in the hospital evaluates an entire feeding with you to help you feel confident.
• Arrange for a lactation consultant visit and a baby weight check as soon as possible after leaving the hospital.