Do you think nipple shields interfere with milk transfer?

[Nipple_nectar]

I am just wondering what your opinion is on the use of nipple shields? I have read conflicting info on them and was wondering, do you think they still contribute to weight gain issues or cause nipple confusion?

[Sharon_Mattes]

Dear Wondering:

Good question! If the literature you read is published before 2001, you will find negative
results concerning nipples shields. However, the product has changed - shields are now
much thinner and 'contact' shields (have a cutout by babies nose) allow baby to smell and
touch the breast encouraging better interaction and skin contact.

The current research by Rush University Nursing Hospital and their premie program has
shown surprising results with use of shields with pre-term infants. Those babies are less
able to maintain the intraoral pressure in the mouth, therefore working harder to feed -
and giving up before they are full. With a shield they have been able to take twice as
much milk with the shield helping them to maintain that vacuum difficult for them.

Also - a nipple shield should never be just 'handed out' as a solution to sore nipples. It is a tool that works well (temporarily) for challenges such as too large or too flat a nipple for a baby to grasp. The very flat or inverted nipple is hard for some babies to grasp which interferes with their latch and causes sore nipples, less milk transfer and slow weight gain and/or reduced milk supply.

I hesitate to offer one to a mother until we work together with all the techniques we can muster to try to get baby deeply attached. If there is an anatomical challenge - then it is preferable for baby to feed at the breast with a shield rather than have the mother both breastfeeding and pumping to offer extra milk or maintain her milk supply. If the shield helps to get baby recognizing that there is milk in the breast and he feels good about it - he will eventually move to breast only when he is 'able'. Sometimes it takes some time and growth to get there. Most moms only use one for a week or two - others may use a shield for several months - but if it keeps mom and baby together - then I see value in its use.

Since the shield is artificial and not soft and pliable like a breast nipple, it could contribute to a baby preferring it to the breast. However, if a bottle nipple is not introduced baby only has two choices - 1) a nipple with a shield or 2) a nipple without a shield. :)

A baby using a nipple shield should be observed for appropriate weight gain - as should all new babies. Counting for sufficient wet and soiled diapers will tell an accurate story about how much baby gets at breast - as long as breast is the only milk he receives.

Hope this answers your questions. Warmly, Sharon