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NIPPLE SHIELDS FOR BREASTFEEDING
I was alarmed when I saw nipple shields on so many Pinterest “breastfeeding essentials” lists. Pinterest is the place that so many new and expectant moms go to see what accessories they will need for breastfeeding. They want to be ready.
I started reading the mommy blogs about breastfeeding and found the same thing.
Once upon a time if I recommended a nipple shield a mom often told me that she had heard they were bad to use.
That is clearly no longer the popular thought.
But not every mom needs a nipple shield for breastfeeding! Not even most moms need one.
What is a Nipple Shield?
A nipple shield is a covering that goes over the nipple during feeding. They are made of thin, flexible silicone and have holes at the end for the milk to come out.
They can help with breastfeeding in certain situations. “Can” is the operative word here.
They can also cause a variety of breastfeeding problems.
Is a Nipple Shield for Breastfeeding Good or Bad?
They are a tool to use for certain problems with breastfeeding. If they are the right tool they will be helpful. If they are the wrong tool they can be harmful.
Even if they are the right tool they need to be used properly.
Why Did Nipple Shields for Breastfeeding Have a Bad Rap?
Nipple shields used to be made of thick rubber. Sometimes actually rubber bottle nipples were used. This caused a lot of problems with sensation and a baby’s ability to get milk out.
Reasons to Use a Nipple Shield
- Inverted nipples
- Very flat nipples if a teat can’t be formed
- Latch difficulty
- Premature babies
- Overabundant milk supply
- Forceful let-down
- Sore nipples
- Babies with a bottle preference who refuse the breast
Bad Reasons to Use a Nipple Shield
- Feel like everything else has been tried
- Heard that everyone should have one
- Sore nipples when the problem that caused them has not been fixed
- A friend used one and said it helped her
- This may be true but the reason she used it may be completely different than your problem
What Are the Disadvantages of a Nipple Shield?
A baby may not be able to suck strongly enough to pull enough milk through the shield.
In some cases, a mom’s milk supply may decrease with nipple shield use.
Should I Try a Nipple Shield?
If at all possible, a lactation consultant should check out your problem. She can help you figure out if a nipple shield would be helpful for your situation.
If you can’t see a lactation consultant in person, do a virtual lactation consult.
How Do I Know What Size Nipple Shield I Need?
There are actually different sizes of nipple shields. The right size is determined by the baby’s mouth size and the size of the mother’s nipple.
They may be described as extra small, small, medium or large or they may have mm sizes, usually 16, 21 or 22 and 24.
The Medela Extra Small is used for babies with very small mouths, usually premies. It might also be used for a mom with very small nipples.
When I worked with a newborn I almost always use a Small. These are 20 mm. This is the size that works for the average size newborn.
An older baby or a mom with larger nipples may need a Medium, 24 mm.
Some women have nipples that are too large for the Medium and a nipple shield will not be an option for them. It will be too tight a fit.
A nipple shield that is too tight on a mom’s nipple can cause nipple damage. A nipple shield that is too large for a baby to latch properly will result in the baby getting little or no milk.
I would discourage using a nipple shield that doesn’t have any size.
How Do I Use a Nipple Shield the Right Way?
There are three important things to remember.
1. The nipple shield needs to be applied the right way.
The nipple shield should be partially inverted and then rolled over the mom’s nipple. This creates a little bit of suction which helps the shield stay in place. It also helps draw the milk out.
It is easier but will not be nearly as helpful to just place the nipple shield over the nipple.
2. Make sure the baby is getting milk.
- You should hear swallowing every 1-2 sucks after the milk has let down.
- If you start using a nipple shield before your milk has come in you won’t hear swallowing as that frequently. It may be only every 5-6 sucks. You should still see some colostrum in the end of the nipple shield. If you just see bubbles that is probably saliva.
- There should be milk in the shield when the baby comes off
- Your baby needs to be latched properly when you are using a nipple shield.
- He needs to be drawing a lot of the areola into his mouth.
- You shouldn’t be able to see the part of the shield that covers the nipple when he is sucking
- He should not be bopping off the shield.
3. You should be pumping after breastfeeding with a nipple shield. The exception to this is if you are using a nipple shield for an oversupply problem.
If you use a nipple shield long term chances are good that you won’t have to pump the whole time. It’s best to be safe and pump in the beginning.
You do not pump with the nipple shield in place. The nipple shield is only for breastfeeding.
A mom is usually using a nipple shield for breastfeeding because there are problems. It seems better to prevent an additional problem occurring with supply by pumping.
Too much milk can be overwhelming to some babies. They choke and sputter and sometimes won’t breastfeed. If this is why you are using a nipple shield you do not want to pump after feedings. You wouldn’t want to do anything that is going to increase milk production.
Make Sure a Nipple Shield Is Not Causing Problems
- A visit with a lactation consultant is strongly advised.
- She can weigh your baby before and after breastfeeding with the nipple shield. This will let you know if your baby is able to get enough milk out with the nipple shield. If your baby can’t get enough milk with the nipple shield then it will not be a good tool to use.
- Track your baby’s weight gain when you are using a nipple shield for breastfeeding. This is important.
- Weekly weight checks are recommended. Normal growth lets you know that your baby is continuing to get enough of your milk with the nipple shield.
How Do I Wean From a Nipple Shield?
You only want to use a nipple shield for as long as it is needed. For some moms that will be the whole time they are breastfeeding.
I have talked to moms who felt constant pressure to stop using a nipple shield. Moms have told me that they felt like failures using it. Some even said they felt like they were cheating by using a nipple shield for breastfeeding.
- Try no nipple shield every few feedings.
- If that doesn’t work, then try every few days. Still not happening?
- Try every few weeks. Still need it?
- Try after a month.
Is It OK to Use a Nipple Shield The Whole Time I’m Breastfeeding?
Yes. If this is what you need to continue breastfeeding, absolutely.
Don’t ever feel bad for using a nipple shield if it is making a difference for you.
Where Can I Get a Nipple Shield?
A lactation consultant will have them. They also sell them at Target and Amazon.
Medela is the brand that I have used for 25 years. They are very thin. A nipple shield should look like a person’s nipple. It should not look like a bottle nipple.
Tips When Using a Nipple Shield for Breastfeeding
- Get 2 or 3. Nothing strikes fear in a woman’s heart like not being able to find her nipple shield when it is time to breastfeed.
- Put them in the places where you will be breastfeeding. Put two! If one drops on the floor you want another to be ready to go.
- It needs to be washed after each use.
Lactation Consultants and Nipple Shields
I’ve said it several times already. It is best to work with a lactation consultant before you use a nipple shield for breastfeeding.
- She can help you determine if it is the right tool for you.
- She will show you how to properly apply it.
- She can help you determine if your baby is getting enough to eat with a nipple shield.
- She can show you how you can tell if your baby is getting your milk out with a nipple shield.
- She can help you monitor your baby’s weight.
- She can help you figure out when you should try to wean off of it.
Nipple shields are an awesome tool for moms who have certain breastfeeding problems. Just like any tool, they are only useful in the right situation.
In the wrong situation they will create more problems. And who needs that?
NIPPLE SHIELDS FOR BREASTFEEDING
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.