Written by The Candices of GoldiLacts (IBCLC & CLS)
Nipple shields are often the subject in the home of a new baby. Many wonder about the pros, cons and reasons for using them. Some have received advice and recommendations from friends or family members, saying they used and loved them. Shields are a wonderful invention indeed and certainly have their place in the lactation world.
Often made of soft, thin, and flexible silicone with holes in the tip to allow milk to flow through, they lay comfortably over the nipple and areola area of the breast to assist during breastfeeding. Essentially they help baby get a better grip onto the breast, providing firmer stimuli than a soft nipple. This can be a huge help for babies with trouble latching onto the breast.
With all things breastfeeding, what works for one parent, may not be the best choice for another. The usage of items such as nipple shields should be based on the individual situation. In some parent/baby dyads, shields are absolutely necessary, and the benefits may outweigh the cons. It is important to use them correctly to ensure milk transfer and protect milk supply, ensuring that a dependency is not created if the goal is for the shield to be removed at some point to allow the baby to latch naturally. This can most definitely be done, and, in most cases, the shield can be removed after a few weeks! In other cases, it is a part of their long term plan.
Professionally, we use nipple shields most as a stepping stone when a baby is having trouble transitioning from the bottle to breast, born prematurely, has a high palate, ties or other oral restrictions that may inhibit them from latching onto the breast fully. It can also be a personal choice of the breastfeeding parent to use a shield for physical, mental or emotional comfort - and we should always be in support of what feels best for them. Each individual situation should be assessed by a lactation professional to see if the shield is the best option, considering the unique breastfeeding goals.
Nipple shields are often given during the first week after birth unnecessarily. Often times they are given as a first resort to resolving a parent's nipple pain while nursing in the early days. This can cause issues with future latch success and milk supply and should be avoided unless there is a true medical need or physical characteristic that is making it difficult for baby to latch.
Nipple shields are not a long term solution for pain during nursing. The best thing to do in this situation is to assess WHY there is nipple pain and trauma while nursing. There is always a reason for nipple pain or trauma at the breast, and breastfeeding should not be painful! Most often, pain while breastfeeding is due to a shallow or ineffective latch, incorrect body positioning, or the presence of oral restrictions and/or overall body tension. It is critical to get these assessed by a professional because all of these can affect baby's ability to transfer milk thoroughly and therefore cause a reduction in milk supply.
Shields are also sometimes given for inverted, short or flat nipples. It is important to know that babies BREAST feed (they don't nipple feed!), and oftentimes, babies can nurse perfectly with all nipple shapes. Many times our clients have been told they have flat, short or inverted nipples when in fact, they don't! Nipples spring into action during lactation and change physical characteristics during the feeding process. This is another reason why we stress the importance of being thoroughly evaluated by an experienced lactation professional.
While the use of the nipple shield is almost always temporary, many parents have used them for their entire breastfeeding journey with a ton of success! Again, it is important to use a shield with the help of a lactation professional's support, guidance, plan of action, and ongoing follow up. Once you have a firm grasp on your plan of action and feel confident with the direction you're headed, the use of the shield will be more realistic, and you can understand the reasoning behind the need to use it.
The most important thing to remember while using a nipple shield is protecting the milk supply and effective milk transfer to baby. If baby is having at least 6-8 wet diapers within a 24 hour period (along with some juicy poopies), gaining weight, and their paediatrician approves of growth and development, that means baby is getting enough breastmilk. These things combined can mean your milk supply is doing great, and the shield is working! Baby's progress is always the best indicator of milk supply and transfer.
Sometimes there is a higher likelihood of clogged milk ducts with the usage of shields because they may block the ability for some ducts to be fully stimulated at each feed. If this is happening, get with an IBCLC (International Board Certified Lactation Consultant) to assess and create a plan to avoid and ensure the shield is fitting and being used correctly. The best thing for milk supply, milk transfer and reduction of clogged milk ducts is a well-latched baby, and, most often, a skilled IBCLC can help so much with this!
Remember, your journey is YOURS. If you are happy with the plan and what you are doing is working great for you and your sweet babe, then keep up the amazingness! Breastfeeding journeys are very personal and always vary from family to family!
Sending you all the love & liquid gold vibes!
The Candices of GoldiLacts
IBCLC & CLS