Nipple Shields - What Are They? How Do I Use Them?

It's universally accepted by moms and now physicians that breastfeeding is the best nutrition for their new baby. That doesn't mean it is always easy. About ninety-two percent of new mothers reported breastfeeding problems in the first week home from the hospital. Half of those mothers said they felt they were experiencing latch problems or another feeding issue like nipple confusion. Nipple shields are an often recommended solution by hospitals and doctors, but how do they really help? Are they the best choice for your nursing hiccup?

What Is a Nipple Shield?

Nipple shields are thin, clear, soft silicone covers for a breastfeeding mother's nipples. There are holes at the tip to enable milk flow. There are dozens of brands and types of nipple shields made for every possible need and nursing complication. Nipple shields can be used to work through latching problems, sore nipples, or psychological barriers around nursing. Shields should only be a temporary solution, though, as they can lead to supply decreases and long-term confusion for the baby.

Different Types of Shields and When To Use Them

There is virtually a shield for every conceivable complication from nursing. Below we've outlined just a few options you have. Because of the variety of options, a trained lactation consultant or breastfeeding counselor should help you determine the right shield for your complication.

**Please keep in mind that these suggestions are based only on research. I do not personally endorse any one of these products, nor am I being paid to promote or sponsor any nipple shields. Like you, I'm just a mom looking to make the best-informed choices for my baby**

Shields like this Phillips Avent Nipple Protector are excellent for minimizing silicone and keeping baby able to touch and smell mom. The unique shape is different from the standard circular silicone. It keeps your baby's nose from feeling silicone, instead allowing them to touch your skin during nursing. The minimal silicone surrounding also allows you to manipulate your breast more freely to have more successful nursing sessions.

These Lansinoh Contact nipple shields are known for their low profile design. They are especially useful for latch issues originating from your baby's side. Babies with a tongue-tie or short tongue might benefit from this or a similar nipple shield.

Haakaa hand expression pumps are trendy right now (with good reason!). This Haakaa nipple shield is one of a kind. You probably have already noticed the unique shape of the nipple. This particular shield is great for transitioning a baby from bottle back to the breast.

Cradle Plus nipple shields are extremely popular with new mothers because all shields come with breast shells. This shield is designed to promote a consistent flow and keep milk from pooling inside the nipple. This particular shield is great for working with dry, cracked, and sore nipples.

One of the most common reasons a mother might need to use a nipple shield is if she is experiencing inverted, flat, or dimpled nipples. This type of shield helps draw out the nipple before nursing.

Pros and Cons of Nipple Shields

Nipple shields can be an essential tool for mothers experiencing breastfeeding complications. Nipple shields allow you to get a deep latch while nursing so that your baby can get sufficient nourishment from breastfeeding alone. Shields can help keep you breastfeeding instead of forcing a transition to a bottle over concerns about your baby's ability to get enough nourishment.

While solutions are great for some problems, they do not come without their own pitfalls. Nipple shields should never be the first option for breastfeeding issues. An experienced, trained lactation consultant or breastfeeding counselor can help you determine what other approaches you can try before resorting to nipple shields.

The number one concern when using nipple shields is your baby getting enough milk. Because using a nipple shield can lead to the breast not being fully emptied, your baby's weight should be monitored closely. It is not uncommon for your baby's weight to decrease when using a nipple shield; however, keep in good communication with your pediatrician to ensure it is an acceptable decrease. Your breast not being fully emptied during feedings can also lead to a reduction in your breast milk supply. It is of the utmost importance you enlist a professional's help in ensuring you are using shields that fit correctly. Incorrectly fitting shields will not adequately compress the sinus behind the areola, which will contribute to not fully emptying the breast of milk.

Shields should only be used for a few minutes at the beginning of feeding, so your baby does not become accustomed to the shield. You want your baby to become used to feeding directly without a barrier.

Precautions For Shields

As with any product you are using for breast milk and feeding your baby, you want to make sure you are cleaning your nipple shields and breast shells well. If you are experiencing cracked or bleeding nipples and need to use, shields try to use ones that allow for sufficient airflow and use them as briefly as possible. Specific shields or excessive use can actually make nipple soreness worse. Consulting with a trained lactation consultant can save a lot of pain and discomfort when using nipple shields. In addition to ensuring the right fit, they can advise on the way to alleviate soreness and damage to nipples and how to properly use nipple shields on damaged nipples.

Weaning the Shield

Weaning from the nipple shield will be something that requires time and patience. Much like weaning from breastfeeding, your baby may not be accepting of the idea. For some babies, it is much easier to breastfeed with the nipple shield in place. If you have used it quite a bit or for an extended period of time, they are likely to protest stopping it. When weaning your baby from the nipple shield:

1. Watch for hunger cues and nurse often. Hungry babies are impatient babies, and if you wait until your little one is in full-blown hunger mode, you will have a harder time getting them to accept the latch without the shield. You will also have less time to work with because you will be starting with a very hungry baby.

2. Do not avoid the shield if your baby is upset. This is a process and will take time. If your baby is getting frustrated with latching, go back to using the shield for that feeding and try again without next time.

3. Hand express before latching and leave some breast milk on your nipple to attract your baby to latch. If your breasts are engorged or hard, hand express or soften with a pump just enough that your baby has an easier time latching. After your baby has gotten a good latch and nursed for a few minutes, try removing the shield and immediately latching your baby again.

As with any breastfeeding complication, you should always feel comfortable seeking out the advice of a trained lactation consultant. If you do not have a lactation consultant available in your area, see if there is a La Leche League or Breastfeeding USA chapter with volunteer counselors. And if physical help is not available to you, there is always the online forum. Many Lactation Consultants will do phone or Skype consultations to at least discuss your challenges with you. Join our Facebook group for more support from breastfeeding mothers like yourself.

References:

Agi, R. (n.d.). Nipple shields: What you need to know. Retrieved March 14, 2020, from https://www.thetot.com/baby/nipple-shields-what-you-need-to-know/

Huggins, K. (2010). The Nursing Mother's Companion (6th ed.). Boston, MA: Harvard Common Press.

Shute, N. (2013, September 23).

To Succeed At Breast-Feeding, Most New Moms Could Use Help. Retrieved March 14, 2020, from https://www.npr.org/sections/health-shots/2013/09/23/225349120/to-succeed-at-breast-feeding-most-new-moms-could-use-help

Stanford, K. (2019, August 20). The 8 Best Nipple Shields for Breastfeeding Moms. Retrieved March 14, 2020, from https://www.whattoexpect.com/baby-products/feeding-nutrition/nipple-shields-breastfeeding/