Nipple Shields - Good or Bad?
Nipple shields get a bad wrap a lot of the time. I myself have shunned them in my career as a doula. Which is crazy because I actually used them successfully with my daughter. When she was born, she was my third and I figured I knew what I was doing. She'd lost a little weight but not enough to be a concern. However when we got home, things weren't going well. She was lethargic, feeding became difficult and even with a bottle of formula we struggled. After some projectile vomiting of every thing I'd put into her, we headed back to the hospital. She was dehydrated and her weight loss got worse. We ended up being admitted into the NICU, and upon further investigation by the pediatrician and the lactation consultants, it was discovered that whenever she opened her mouth to feed, her tongue went to the roof of her mouth and my nipple kept slipping under her tongue. Not conducive to successful feeding. And she ended up destroying my nipples as a result. This led the amazing Lactation Consultants to suggest a nipple shield. And we ended up breastfeeding for about 9 months. Which was much longer than my other two children.
Let's start by talking about the good, the benefits of nipple shields. Because they can actually be quite beneficial, especially the current version of them, made with thin flexible silicone. Mine were quite thick and made of rubber back in the day.
These shields can help if you are having difficulty achieving a good latch and if you have short, flat or inverted nipples. They can help extend the nipple to touch the roof of baby's mouth which can trigger the suck reflex. Which is why a deep latch is so important. But with short, flat or inverted nipples, this can be difficult to achieve, especially in the early days when baby and you are both learning.
They also help if you have been struggling with achieving a good latch and your nipples have been damaged as a result. If your nipples get cracked and bleeding from a bad latch, how do you heal when you are still trying feed baby, fix your latch and all the while you are in pain and bleeding? A nipple shield can help protect you while you are learning good latching techniques and healing yourself.
With my experience, my nipples were so damaged, the shield would fill up with blood in the very beginning while I was healing. It was a bit scary.
*Tip - After each feed, starting right from the first latch, hand express a little colostrum out and rub it into your nipple and let it air dry. The colostrum contains so many good things including white blood cells that can heal any micro damage that start wit those first initial latches.
Finally, they can be helpful, if for whatever reason baby has been given bottles but you want to feed directly from your body, baby may need some transition time. Using the nipple shield can help with that transition from bottle to back to breast. And while I didn't it suggested anywhere, perhaps it can help the other way too, in transitioning an older baby to the bottle, especially if they are going to be away from you for an extended time such as starting daycare but are refusing the bottle.
Now, let's talk about the bad wrap that nipple shields get. Firstly, they won't fix the underlying problem that caused the need in the first place. And unfortunately, once a shield is in place, people think that's it, you're done. But you aren't. The issue still exists and still needs to be fixed.
If the reason for the shield is a bad latch, you still need support and help to correct it. Any lactation consultant who recommends a shield should also put a plan in place to correct the issue and work with you to get you feeding without the shield. Remember, a shield is not a solution, it is a temporary bandaid.
There used to be a big concern about nipple shields causing supply issues. And I will say, this was true, but not necessarily now. With the older, thicker rubber models, it would decrease the sensation you felt, which would portentially lower oxytocin levels, which would lower supply. However, now a days, with the thin silicone ones in use, this isn't necessarily an issue. But the caveat is, the shield must be used properly. If it is not, it can lead to slower feeds, with baby getting less milk resulting in slower weight gain and supply issues. And if used for an extended period of time this can result in long term supplementation and supply reductions.
And finally, my main reason why I dislike nipple shields. And really, it isn't the shield itself, or the use of it. Its that when hospital LC's or postpartum nurses suggest them when you are in hospital for the 24-48 hours after baby is born, there is no plan in place to get off the shield. You are given it, shown how to use it and then sent home without any follow up. It is now up to you to figure out what to do or hire your own Lactation Consultant to help you get off it. Plus, most times, while in postpartum, you are given the shield and still not show how to fix the latch, which is key to getting things working. Now this isn't a dig at LC's or postpartum nurses. They do their best with the resources they have at their disposal. But hospitals would be wise to take a look at the breastfeeding rates for those that want to, after parents leave the hospital, and invest some funds in easy to access clinics and support groups for those choosing to breastfeed. But instead, all that is possible with the limited time and availability of LC's and funds needed, the best we can hope for is a 10 minute visit, some information and a shield. All the while, feeding parents are concerned about getting food into their baby as they struggle with healing and mentally processing their birth.
Back when I had my experience, I was shown how to achieve a good latch and we really weren't able to leave the hospital until things were working without the shield and my daughter was gaining weight appropriately. I continued to exclusively breastfeed her until she was 9 months old which was more than double the amount of time I fed my first son.
So, is a nipple shield good or bad? that's probably still up for debate, but my advice is, if you use it make sure you have a solid plan in place to fix your latch and get feeding going well without it. Good luck!!!
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