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In defence of nipple shields

7/2/2013

28 Comments

 
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Again this week, I read a comment by a leading breastfeeding expert tutting over the use of nipple shields. 

Of course, this person has decades of experience.

Of course, there are plenty of times when nipple shields are used incorrectly and over-enthusiastically .

Of course, when they are used without seeking access to other breastfeeding support they can mean supply issues, continued nipple pain and damage and a situation that can be challenging to unpick.

But can I please just take one moment to say that sometimes they can be bloody marvellous.

I’m not ‘supposed’ to say that. I’ve heard lactation consultant colleagues say, “Oooh, I hate nipple shields.” I’m meant to be down on them and focus on all the disadvantages.

But sometimes I just feel they need a little bit of defending.

I don’t know what’s going on with tongue tie at the moment. It seems like every breastfeeding drop-in group I visit has at least a third of babies who are post-frenotomy (tongue tie ‘snipping’) or they have been diagnosed and are waiting to be seen. Obviously the proportion of babies who come to get breastfeeding support will inevitably include more struggling with tongue dysfunction - however the numbers still seem ludicrous.

 I’ve seen mums who are breastfeeding several months after an initial nightmare month living with tongue-tie and a nipple shield has made all the difference.  Tongue tie is often accompanied by a high-arched palate or ‘bubble’ palate as when a baby is in utero the tongue hasn’t been pressing up against the soft bone of the palate due to its restriction and the palate doesn’t end up being smoothed into the typical gentle arch. And although babies can feed just fine on flatter nipples and even inverted nipples, they often do like to feel something touching their palate and triggering their sucking reflex. And if that palate is an extra centimetre away, that can be tough.  A baby may struggle to get purchase. They may appear to be searching for something and become frustrated. Finding a way to get baby to latch on and stay on may not always be easy.

Babies with tongue tie and high palates can latch on effectively but it’s not easy for everyone to find those ways on their own.

There are ways to get babies to latch on beautifully to flat nipples but it’s not easy for everyone to find those ways on their own.

In some cases, nipple shields can be a useful tool. The baby receives that palate stimulation and settles into a fabulous rhythm of deep swallows and great chin movements, milk is transferred and it’s hard to see what’s so evil about that.

Those who demonise nipple shields might have talked about the need to ‘work harder’ to find a latch that works. That’s fine - but when it’s 2am and mum is exhausted and baby is exhausted a bottle of formula may well be an appealing choice when your nipples are already sore and feeding has never been easy.

If we make nipple shields the ‘bad guy’, you may find that less feeding happens at the breast. Not everyone has a breastfeeding specialist sitting in the corner of their bedroom behind the nightlight. Or even access to good quality breastfeeding support throughout the week in the day time.

This morning I worked with a mum who had nipples that looked naturally quite different. One had a wide barrel shape and a length of about 15mm. The other was a slight dome rising no more than 3mm above her areola. She had been feeding successfully on one breast but when it came to the flatter side, baby was confused and frustrated. He had never really latched on for more than a few moments. Several weeks on, she was feeling desperate. She had been supported to try many positions by several breastfeeding counsellors and lactation consultants. She had visited a cranial osteopath. But the reality was that her son was used to the sensation of the longer nipple and the other side was less straight forward and he was struggling to move between the two. Perhaps she could only feed from one side and express the other? Perhaps she could just lactate on one side?

She tried a shield today and, for the first time ever, he moved immediately to deep chin movements, audible swallowing and mum said, “Yay!”.

She actually said “Yay!” quite a few times.

I would defy someone who had spent time with that mum and heard her history and worked with her to then say, “I hate nipple shields”.

There are certainly times when they don’t work well. I’ve also been to a group and a mum has shown up using shields to help her cope with sore nipples. The low point came a couple of nights ago and she couldn’t continue feeding  just on the breast. Even in that moment, it’s hard to argue it would’ve been better for her to stop breastfeeding and use a bottle in order to ‘rest’ completely. The shields allowed her to keep going and avoid the complication of using a bottle. However the shields were not her solution. Thankfully she sensed that and knew to come to a group and get support but I wonder how many women don’t. Her positioning and attachment could certainly have done with some improvement. She was leaning forward and ‘offering the breast’ and then pushing it in baby’s mouth without really waiting for a gape or bringing the baby to her. Her nipple was coming out after a feed flattened and compressed and was visibly damaged along the ridge where it was flattened. There were lots of things that could be improved. And the shield didn’t help with any of that. But it helped with her psychology and she came to the group. It kept her going.

Shields don’t help with sore nipples. They can exacerbate issues where babies have insufficient gapes and the baby just then transfers their insufficient gape onto the shield. But if the shield means that mum can cope with breastfeeding until she does manage to get the right support, if they stop her giving up, then that surely is a positive.

Shields are connected to a lower milk supply. Possibly because hormones aren’t being stimulated in quite the same way even through the modern thin silicone shields. Possibly because the people who resort to using the shields have issues that are the true cause of milk supply reduction. It can be wise to stimulate your supply using some additional expression if you are using shields and keep a closer on on baby’s weight gain. However I’ve also seen shields get a mum through a difficult couple of days when she had too MUCH milk. After struggling with oversupply and overactive letdown, her baby choking and spluttering with every feed, she found using the shields tided her over until she was able to get proper support and information. The baby was able to come to the breast without being flooded and her alternative would’ve been expressing and bottlefeeding.

If we demonise nipple shields, we reduce options. Options that actually might help when the next breastfeeding group is in two days time and the breastfeeding helpline isn’t open for the next 10 hours. And when the temptation is to pick up a bottle when it’s really not want you want to do.

You can use a shield and practice good body positioning and nose to nipple and head tilting and gaping. The baby works at the breast and is held close and does lots and lots of useful and valuable things and transfers milk as it gradually thickens and this is all still breastfeeding.

If you’ve been a breastfeeding supporter for a gazillion years and you’ve always managed to get babies to latch on superbly and you’ve never needed to use a shield – that’s dandy. But I will hold my hand up and say that sometimes I’ve worked with mothers who did use a shield and it made them happy and they felt great and the baby felt great. They went on to reach their breastfeeding goals, often weaning off the use of the shield with very little difficulty.

I think sometimes nipple shields deserve a teeny little ‘yay!’ They aren’t right in MOST situations and good quality breastfeeding information usually means that they are not needed.  If they are going to be used, they should be used with support from someone who is qualified in breastfeeding. But in a minority of cases, they can be bloody marvellous.

28 Comments
Jenny Emerson
7/3/2013 02:18:09 am

My nipples got so badly shredded that I lost a crater from the right hand side. No-one could find anything wrong with my latch, except it hurt and I got lipstick nipples. When the left side started feeling reasonable again at 4 weeks but the right was still so painful I had to try to psyche myself up to feed, kept chickening out just as I was about to latch him on and spent the first minute or so rocking back and forth in agony I decided to try a nipple shield on that side. It gave instant relief. It took 12 weeks for it to heal enough that I could brave "naked" feeding again, but we got through it and I'm still (tandem) feeding him at 34 months old!

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New mum
1/24/2014 05:24:44 am

I just wanted to say thank you for defending nipple shields and more people should accept that in some circumstances these are a godsend

. I have a son with a very high palette, I was ripping myself apart with guilt and distress because I had to use a shield, I have seen three breast feeding specialists ontop of my midwifes and local health centre.they have confirmed he is physically unable to latch on and it may not happen, also even if it does it is very likely to cause trauma to the nipples. So I'm my case nipple shields and expressing is my only option because without them he wouldn't get any milk at all. I wish people would not frown upon the shields because I'm sure if mums could feed without them they would

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Michelle
5/12/2017 11:13:08 pm

Lovely to know I'm not the only one. Post frenetomy and with high palate, my nipples were munched. My bub is 9 weeks and we're working on desensitising her sensitive gag reflex. Without nipple shields I would have been pumping exclusivity and that isn't as convenient as a breast with a nipple shield

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Laura
2/21/2014 08:05:43 pm

I am tongue-tied and all 3 of my boys were too. They were all clipped within 1-3 days of birth. I also have a very overactive letdown and an oversupply issue which lead to extreme engorgement and nipple pain. I used the nipple shield from day 1 or so with all 3 of my babies and successfully broke them off of it by about 3 months and continued to nurse each till 2 years old. In my situation, nipple shields weren't demonized and I only learned of the negatives from the internet...so much so that with my third I was determined not to use the shield and after all the same issues the LC said, "you might just need to use it for now." The shield (and some serious determination) enabled successful BF'ing in this house, for sure :)

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Suzie
7/13/2015 11:35:28 am

Thank you for this.
With my daughter I had recurrent skin infections on my nipples, they looked horrific, pus, blood etc. I started using nipple shields as it was obviously agony, but was made to feel like a failure by a BFC at the support group I went to.
However I spoke to a family friend who was a breastfeeding supporter and she could see how much the shields were benefitting me and my baby.

I used them until the skin healed and then breastfed without them 15 months. Without them I would have definitely stopped.

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Ann
10/7/2015 02:38:12 am

Thank you SO much for writing this. I'm using a nipple sheild with my second baby and am grateful to have one. My first never latched properly and I spent the first 6 months with him pumping exclusively. It was a beatdown physically and emotionally. My first feed with my second, I had a wonderful nurse who immediately saw the problem with my nipples and offered the sheild. It worked from the very start. I've had absolutely no problems with supply, tons of dirty diapers and baby has gained back birth weight plus some, an oz a day since leaving the hospitial. I'd like to ween off the sheild completely at some point, baby is 13 days old and we've had successful feedings without the sheild but still need it a lot. So glad not to be tied to a breast pump all the time.

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Delia
5/3/2016 04:11:00 am

Nipple shields were the only thing that even made it possible to have a breastfeeding relationship with my son. I was told he had a tongue tie at birth and that the Dr would clip it when she did his circumcision. Being a first time mom and knowing nothing about tongue ties, I trusted the doctor. My son couldn't stay latched, even after the procedure. I was given a nipple shield while in the hospital. He went straight to nursing that way. I recently got his posterior tongue tie that was missed at the hospital along with his class IV lip tie revised. He has a really high palate and we still are working on weaning off of the shield, but I am extremely thankful I have been able to breastfeed my son with the aid of a nipple shield.

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Greg
8/16/2016 11:48:02 am

I wish we'd known about this when we had our first. She has a high palate and was unable to latch, even with so-called "breast is best" nurses practically slamming the babies head onto the nipple. My wife was so upset feeling shamed by the whole process.
I'm certain the simple mechanical problem that a high palate presents to latching was the issue. We moved to breast pump and bottle feeding exclusively and everyone was happy.
This breast shield device would have been a god send !

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Sheree
5/12/2017 01:20:26 am

I had extremely tender nipples (and general sensitivity all over) in the later stages of my pregnancy. When my son was born I was in torture feeding him- it felt like a serrated knife rubbing on my nipples and I was in so much pain that I was kept in hospital longer. I had consults with nurses, doctors and lactation people but they all felt that my sons latch was fine. At only 3 days old, I was in so much pain that I didn't want to feed and was seriously discussing putting my son on formula when a nurse suggested trying nipple shields. I never looked back. I used them regularly for the first month or so until my body settled down and then was able to feed naturally. I'm sure that my issue was simply that hormones in my body made me extra sensitive particularly on such a tender part of the body. Nipple shields saved me a lot of tears and enabled me to enjoy my son rather than fear him. I am pregnant again and will be packing the shields into my hospital bag in case I have the same experience again.

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Michelle
5/16/2017 11:36:28 pm

Thank you for this!!

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Kieren
7/22/2017 10:16:42 am

Thank you!

I have had the easiest pregnancies and unmedicated births, only to be followed up by the most horrific breastfeeding experiences. Oversupply, large breasts, and inverted nipples have created lots of problems for me every time I've nursed a newborn. My first two babies were champion nursers, so the pain and problems were only felt on my end. I nursed each child for over a year.

My third and fourth babies didn't do as well. Both had a lot of trouble latching onto the more severely inverted nipple. With my third, I battled bad nipple damage, thrush, and mastitis all within the first month, because of the aforementioned issues. I finally tried a nipple shield and it allowed my baby to latch and saved me from the excruciating physical and emotional pain of nursing on my "bad" side. I was able to wean off of it after 6 weeks and we nursed for over a year.

My fourth baby is currently 3 weeks old. I have learned to deal with my engorgement and oversupply, so I thought it would be smooth sailing. Wrong! That one nipple is still too hard for a newborn to latch onto, so we are using the shield. Because I've been through this once before, I'm not as scared of the shield. I'm thankful for it! Hopefully we will be able to wean off of it in a few months. Until then, I am enjoying the newborn phase more than I've ever been able to in the past, partly because of the shield.

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Marion
10/3/2017 06:23:35 pm

Great article.

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Shontelle
3/2/2018 09:47:06 pm

Thanks for this great article. Any suggestions for getting a 7 month old to accept a nipple shield? He has a high arched palate. My left nipple was badly cracked and took a long time to heal. I was expressing for several weeks on that side. It affected my supply, so when I put my baby back on that side he would get frustrated and rip off,
which led to more damage, and I also had an episode of Mastitis on that side. After weeks of persevering, and advice from a lactation consultant, I have given up on that breast and am down to one. However because of the high arch, that one has a painful crack on the end. I’ve seen a Lactation Consultant recently and she suggested a nipple shield, but he just won’t accept it. I haven’t had pain for the entire seven months, I struggled to get going as I have every time with my babies, but then we cruised along until he was about 4.5 months. The Lactation Consultant said that it’s likely my supply was better early on and he was doing nice big gulps and the nipple was further back in his mouth. I breastfed my first three beyond a year and would like to do the same with this little one, but the pain is making it really difficult. I think I’m also having vasospasms. My little one is doing well on a combination of meals, breastmilk and formula (which I felt I had to introduce when it was clear my left breast supply was inadequate and I was struggling with the right, and he was just holding his own with weight gain). I’d love to be improve the BF though and drop the formula. Any help would be very much appreciated.

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Emma
3/4/2018 07:57:28 am

I’m so sorry you’ve been in pain for such a long time. If there is a significant crack on that side and supply is likely diminished, I’m not sure using a shield on that side is likely to be a resolution even if possible. He is likely to be frustrated about flow and possibly start using compensatory techniques or other behaviours that could cause even more pain.

I would suggest first priority is to get healing happening with moist wound healing and soap and water/ saline soaks and some focused pumping to increase supply with hands-on pumping techniques.

Tricky to advise further without seeing the latch and/ or in what way and at what point he rejects the shield. And to understand what latching techniques you have tried. Also need to make sure shields are sized correctly and put on correctly.

Sorry not to be able to provide an easy answer.

I know of one mum who relactated and used a shield with a mum older baby. For her it was about offering when the baby was sleeping and keeping close at night.

However I’m not sure that’s your answer without a bit of work on supply and healing first. And possibly a bit more work on latch options.

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Maria
5/7/2018 08:43:58 pm

Thanks a lot for sharing a different point of view when it comes to nipple shields.

I use a nipple shield for breastfeeding my daughter since she is 5 days old. It was the only solution I found to avoid formula (not that I have something against it). I have flat nipples and when she was born she couldn’t latch on for a long period of time. She was hungry all the time, she would cry a lot and she was loosing a lot of weight. So The shield really “saved” my breastfeeding experience.

Now my daughter is 4 months old and I still use the shields every time I nurse her. She has been gaining weight beautifully. She sleeps very very well at night and she is a healthy and happy baby. Also, I never had a milk supply problem so i consider myself very lucky.

I try everyday to breastfeed her without the shield but she looks at me desperately when the shield is not on my boob.
I read all over the Internet that nipple shields should not be a long term solution, I am scared I won’t be able to breastfeed my child as long as I would like to (18 months). I tried to see with a LC how to wean her off the shield but she wasn’t very helpful. She will literally force my baby to grab my boob, even if she was crying and yelling. It found that it was a very agressive method...

I don’t have any problem using the shields long term. I got used to them even though I get a bit embarrassed when I use them in public. But I’m very worried i won’t be able to breastfeed my daughter for as long as I want.

Any advice or experience that could inspire me ?? :)


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Emma Pickett
5/8/2018 07:27:36 am

Hi Maria,
You’ve done the difficult bit. You’ve established your milk supply. You’ve got a latch. You’ve got a beautiful breastfeeding relationship that works.

As long as you keep feeding and removing milk, there’s no reason to think you won’t be able to feed for as long as you want to.

However I wouldn’t give up hope of not being able to lose the shield if you want to. The best method would be the opposite of aggressive. You would both be relaxed and feel you are in control. It might be helpful to shape the nipple using a technique like the flipple. She might like the feeling of the breast making contact against the roof of her mouth. Have a look for the flipple on You Tube. Is there an alternative IBCLC around?

One day, it may just happen. Maybe at night when you are both a bit sleepy and the shield is somewhere else!

Don’t give up hope but equally don’t feel you are on a deadline. Very Best Wishes.

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Eein link
8/24/2018 06:14:57 am

Hi, Maria. I’m not sure if you are still BF your daughter but I successfully BF my daughter for 9mo on the shield. I am in the same situation again with my 7 week old son. My nipples were cracked and bloody to point where he spit up blood one night. I turned to the shield after he was 6 days old. I was devastated because I thought we had a good thing going, despite the pain. Even though we are dependent on the shield again, I think back to my daughter and how she nursed for 9 months. I, too, feel embarrassed to use it in public because it doesn’t seem natural but if our babies are thriving then we need to support each other and stop giving shields such a bad rep. I hope you were able to continue BF or that you still are. I plan to do it just as long this time again. Best of luck to you.

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Laura link
6/8/2018 09:47:00 am

Thank you for this very interesting article. I used nipple shields with my first daughter for 22 months after an excruciating few weeks of feeding and her losing 15%. In the first month she had 2 tongue tie cuts, one deep posterior tie, but nothing made a difference. After starting to use the shields she began to put on the right amount of weight and thrived. In the end I never had to top up with formula and she always refused a bottle so it worked well for us.
The only issue was that i was made to feel bad about using the shields, that in some way I wasn't doing it 'properly.
After pre eclampsia and a very traumatic birth I was determined that I was going to be able to feed her exclusively and the nipple shields allowed my to do that.
2.5 years on I have just had my second baby, this time a wonderful birth and no health issues, however the issues with feeding are exactly the same. I started using the shields after 3 days. After 3 weeks she is now just under a kilo more than her birth weight so has done fantastically and is feeding fine with the shields. I had 3 days of pain as opposed to 3/4 weeks last time. I knew that I couldn't go through that again as it would affect my ability to look after my first child. Yesterday she had her tongue tie cut and we tried without the shields, it didn't feel too bad however the nipple was still a little pinched when it came out. Now I'm wondering whether to just continue with the shields like last time or to see if I can go it alone...
After my first experience I read up about using nipple shields and was amazed to read how throughout history women have found ways to support themelves with feeding. It has never been easy for all women to feed and isn't always this natural, beautiful process. Anyway this really helped me to feel better about my choices and I hope it gives some reassurance to anyone reading.

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Rachael
8/3/2018 06:15:14 pm

thank you for showing the good side to nipple shields. without them, i wouldnt have been able to feed after the first week. both my boys were tongue tied and with both my nipples were shredded and bleeding within 24 hours. the pain was unbearable. the nipple shields gave me time to heal and once the tongue tie was cut my babies relearnt to feed properly. i fed my eldest till 13 months and my youngest is 6 months still breastfeeding :-)

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Emma S
2/22/2019 03:29:40 am

So glad I found this article. Thank you! The piece and comments have been extremely useful. My son has a high bubble palate and mild posterior tt but not worth correcting, according to Lactation Consultant seen recently. He’s 8weeks and we’ve been mixed feeding since birth as he was on antibiotics initially. However, i have been trying to get to bf exclusively. Sadly his weight started plateauing and he was getting frustrated at breast and losing latch more with a skquawking sound. Plus my posture was terrible and the techniques I’d learned in hospital were not addressing his high palate. Would nipple shields work for me? LC recommenced biologocal birturing position which we’re trying but I’m not nailing it every time and it feels like we’re starting all over. Sometimes leaning over him in my lap and using gravity seems to work better. I have shields but haven’t used them. I’m worried if we don’t get a good milk transfer going soon my supply will dwindle, although I’m expressing after as many feeds as I can manage and topping up each feed if he needs it. My nipples are in good condition now - or have just become hardened after a bumpy start with mastitis too, but they are different to one another and do come out misshapen regularly. Thanks in anticipation

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Amy
11/28/2019 09:01:11 am

I’ve been using nipple shields for 10 weeks with my second child, after 4 horribly painful weeks trying to improve her latch to no avail.

BF counsellors, lactation consultants, midwives and HVs all tried to help, we had cranial osteopathy (and she also had tongue tie cut and then cut again 10 days later) but she just won’t open her mouth wide enough to get a good latch. They initially affected my supply but I got it back up thanks to domperidone prescribed by the doctor.

I’ve tried occasionally to get her off the shields; she either has no idea what the nipple is or how to latch on, or feeds with a v shallow latch that sees me in horrible pain again. I can’t see how she’ll ever feed without them, which is depressing as they make things tricky when out and about (and I suspect as she gets older, she’ll fuss more and pull them off!).

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Farah
4/28/2020 02:09:05 pm

This is an amazing post, thank you Emma! I couldn’t agree more. I used nipple shields on sore nipples right after birth for a few days and they saved the day and worked a miracle. I’m using them again now at 11 weeks old again for a new reason and they’re saving the day once again!

I have a question Emma, and I wonder what’s your view and advice. How long can I use the nipple shield without getting my DD used to it again and preferring it? I had to introduce it again now at 11 weeks as no other way could get her on the breast for the last 1-2 feeds of the day and when she’s too tired. This is an amazing post, thank you Emma! I couldn’t agree more. I used nipple shields on sore nipples right after birth for a few days and they saved the day and worked a miracle. I’m using them again now at 11 weeks old again for a new reason and they’re saving the day once again!

I have a question Emma, and I wonder what’s your view and advice. How long can I use the nipple shield without getting my DD used to it again and preferring it? I had to introduce it again now at 11 weeks as no other way could get her on the breast for the last 1-2 feeds of the day and when she’s too tired. I’d been giving her expressed bottles at those times of the day before but now I’ve decided to fully breastfeed as much as possible.

Here’s my context-
I’ve been giving baby some expressed bottles (using slow flow teat only) in addition to nursing, for the past 7-8 weeks. In the last 3-4 weeks at least I was breastfeeding once in the morning 8am and sometimes middle of the morning and occasionally one more time early afternoon. On weekends I breastfeed overnight too. The mixed method has been working well she’s been gaining weight and happy and doesn’t have an issue latching on my breast for the breastfeeding sessions.

I notice my milk flow and supply are better and more vigorous in the morning than in the afternoon (can tell from how she sucks and from the pump yield). So she’s very fussy later in the day so much so she doesn’t want to latch and keeps turning away from breast, even when she’s not too tired (trying to choose good timings). As a result our days end on a sad note now and she hasn’t been getting the fullness of a bottle before she sleeps like before. It’s been 2 days now and other than the ending, we’re overall enjoying the closeness again and I’d like to continue, but would like her to be happier in the evening. So I’d love your view and hopefully reassurance about what I’m doing right and perhaps if I can fix anything...

I know she’s hungry later in the day and at her usual feeding times. So for the late afternoon and evening feeds I find myself either having to force her on the breast or giving her an expressed bottle (which I don’t like now that we’re trying to fully breastfeed) - or placing a nipple shield to attract her to latch which she does quickly and then I remove it and she continues to suck my breast normally.. this is happening especially when she’s tired and sleepy.

At those times clearly she is hungry but doesn’t want the natural nipple, but then after I get her on it she enjoys it and finds it soothing. I wonder why this trick works but more importantly how to exit the nipple shield scenario after I reintroduced it? I can’t say she got bottle preference generally. Taking my breast isn’t a problem at other times of the day.

Now that I reintroduced the shield, i wouldnt want to get her used to it again and preferring it, perhaps at other feeds of the day too! I don’t want to swap an issue with another new issue and then we struggle again to unlearn.

Just to add, I’ve also cut out the pacifier since I returned to fully breastfeed.

Sorry for the long post - many thanks for your precious advice and support and time.

Best wishes
Farah

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Anri Britz
6/4/2020 08:12:22 am

I feel much better after reading this. My baby has a high arched palate and I cannot get her to stay on the breast without a shield. I am however still concerned over the arched palate and want to know if the shield will not worsen it or will it have the same effect as normal breastfeeding on the palate? Baby is also picking up weight very slowly, although picking up and it could be in the genes as well because my son also were a lean baby and she is very petite since birth. She seems content after feeds and seem to get enough milk. But the terrible sucking sound it makes while drinking due to the palate along with lots of winds cause her to bring up milk often and she was also diagnosed with reflux. I am most worried about the palate and want to know if it is safe to keep going with the shield and not worsen the palate. It is still better than a bottle right?

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Emma Pickett
6/13/2020 03:13:32 pm

Hi Anri,
Have you managed to get any face to face support? I'm not sure whether someone has looked at your baby's anatomy and supported you to think about different positions or how you are breastfeeding. If baby is content after feeds and gets enough milk, that is to be celebrated. You are breastfeeding. There isn't a lot of evidence around the impact of nipple shields on the palate so it's hard to comment on that. But going without the shield and not breastfeeding doesn't feel like an improvement in your situation. There are lots of reasons why feeding directly at the breast may be preferable to using a bottle. You sound worried but you have found a solution that means you are giving your baby so much. But I just want to check you are getting support in real life. The sound and the reflux sound tough.

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Joanna
6/13/2020 11:48:05 am

My baby was born at 35+3. He is now 2 weeks old and the only way I've successfully been able to get him to feed from breast is using nipple shields as he still struggles to latch. I had several meetings with BF specialist while in hospital and there was no problem with my method, just that he was possibly too little to get it.

We continue to try daily without, but he often falls off after around 1 min and then gets frustrated trying to get back on. The nipple shields have really helped me to develop a bond with my son, and we will continue to try without, but for now, I'm just happy that he is able to get some of my milk this way.

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Haley
5/28/2021 12:58:20 am

Thanks for this post! Have been feeling guilty about using a nipple shield lately. I got him mostly weaned off it at one point for about a week but it was no fun at all. He would constantly fuss and pull on and off and push away from me while feeding leaving both of us frustrated and wet and sticky from my milk going everywhere. I did see a lactation consultant once and she noted that I had a lot of milk and it seemed to come out fast. I figured he was fussy because without the nipple shield, my milk was coming at him too fast. He also spits up a lot and I didn’t want to make this problem any worse as well. So I gave up and started using it again and now he is 10 weeks old. My only breastfeeding issue now is that each feeding takes about 30-45 minutes. He seems to have a good latch, but just feeds slowly and takes frequent breaks from from sucking. Doesn’t usually fall asleep, but sometimes will and I’ll have to stimulate him to keep eating. Do you think this could be related to using the nipple shield??

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Emma Pickett
6/4/2021 02:47:45 pm

Hi Haley,
It's difficult to say for sure. It may be. Have you had a go at using breast compressions and see how he responds to increased flow?

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Alex
11/16/2021 05:33:36 am

Hi Emma, thank you for this post. My son is 9.5 mos and up until about 6 weeks ago he was exclusively BF with the nipple shield other than one bottle of leaked or pumped milk per day. Now that I am back at work, we are only nursing once in the morning (still on the shield) and sadly I think our nursing days are coming to an end because he refuses to nurse for more than a few minutes. However, I think the bottle / age / solids are the reasons and not the shield. Without the shield, I would have never been able to nurse at all. I have sensitive skin and apparently hypersensitive nipples, and initial nipple damage made it impossible to nurse. I was literally screaming in pain in the hospital. And then I met with one lactation consultant a couple hours before we were discharged and she put the shield on me and viola! I could nurse. My son has a shallow latch but no tongue tie that any of 15 LCs have ever been able to find, and I had an oversupply and super fast flow on my left nipple. So the nipple shield was a life saver, and my nipples are still raw to be honest and I don’t think will heal until I’m done pumping. But my son has gained weight and grown beautifully for 9.5 mos and we wouldn’t be here without the shield. It makes me sad and confused when I see posts about how it’s necessary to get off the shield. I tried a few times but it was so painful I just wondered why I was torturing myself when I had a good thing going that was working for both of us. Anyway, appreciate the post and I hope anyone else reading this using the shield knows it’s not the worst thing in the world and in fact it can be pretty great if it allows you to have a BF relationship that you otherwise wouldn’t have.

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    Author:
    Emma Pickett IBCLC

    Find me on twitter: @makesmilk

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    A Lactation Consultant supporting families in North London.

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