why are nipple shields not recommended?

[Ginger]

i have beem using nipple shields when feeding ds- i was given one while in hospital. i find that i can't get him to attatch without one, but now i'm worried that he's not getting enough milk as this morning he was on the one boob for one hour! i had to take him offin the end. do you think that this is cos he's not getting enough through the shield? thanks for your help

[Phoenix]

I've used a nipple shield but didn't learn until after my first the reasons why they should be used with care and for most situations as a last resort. Did you receive any follow up help with an LC with the nipple shield in hospital? Basically they need to be used with ongoing support from an LC or a breastfeeding counsellor and try to get bub off ASAP. Yes they have been known to interfere with milk supply and/or cause some nipple soreness due to friction.
Is there any way you can try to take it off after bub has fed for a little while? Sometimes all it needs is the nipple to be drawn out that little bit and then you can take it off and reattach bub.
perhaps you could give an ABA counsellor a call and chat about trying to attach without the shield so you can stop using it.

[MantaRay]

Gracie, nipple shields IMO, do not deserve their reputation. They can be life savers. They were for me. The reason caution is recommended is that IN SOME CASES they can lead to reduced supply. This is because the nipple is not getting the direct stimulation of skin on skin. I did not have this problem - while I was using them Jack put on twice the average weight gain every week. You sound like your feeding is going well and bub is gaining weight so I would not be too worried. A long feed could just be comfort sucking, or a one off thing. Also, as you say, nipple damage can occur from the baby sucking harder to get the milk. Again, that is not a given.

I did find the nipple shields a nuisance however, so I was glad that I no longer needed them all the time after 3 weeks (when the tongue-tie was snipped) and then was able to stop using them totally by 6 weeks. Depending on the reason you needed the shields, I imagine that you would not need to use them forever, although I know of women who have with no problems. Usually once the bub's mouth gets bigger it is easier for them to attach. Are you trying to attach without them first for at least one feed a day? If you would like to stop needing them then you could try doing that - once a day, or every second feed, or all daytime feeds. Often after a few tries the baby will be able to attach without one when they are alert, and then once they can do that, with a bit more practice they can do it all the time. GL Gracie, it will all get easier sweetie.

[Nadine216]

In my opinion (and it's not a profesional one) I would get him off that shield asap! Even if you have to stay in bed with him the whole day and practice.
Same as with you, they gave me a shield at the hospital. My bub was prem and they told me it's better that way. After a month I brought her home and wanted to stop using the shield, but she would not drink from me directly. We tried for about three days. She just would not drink. She did not pick up weight quickly enough and my milk started to dry-up. I used to let her drink for about 30min per boob!! I was not getting enough stimulation and she was not getting enough milk. I tried expressing, but by that time I was too late. I tried all the remedies to get my milk back, but no sucess. After two months we switched to formula out of desperation and she thrived on that.
So if I were you and knew what I know now, I would teach him as soon as possible to cope without the shield.
HTH

[~Raven~]

Nipple shields helped me to overcome very painful cracked nipples and are the reason I was able to work through it and successfully b/f my first and third babies. My second had no problems.

When my LC talked about them with me she was not against them but she was against using them for every feed. eg you can use them for one feed on then the next feed try without. Bub is still used to feeding without it and the nipple is being stimulated properly but being rested a little from that rough little tounge.

[paradise lost]

Generally they're for short term use for the reasons outlined above - they can interfere with the supply and they don't help bubs to learn how to attach to the breast well without help.

If a bad attachment has been allowed to go on they provide incredibly valuable rest while the nipples heal (though with a correct attachment the nipples can heal even WITHOUT shields), and for some babies (like those with tongue-tie) shields bridge the gap between birth and being ABLE to form a correct attachment. I think the main reason they are worried about is that some people never get a good attachment because they use the shield and without proper support don't learn how to attach and then try without, get injured nipples again, go back to the shield, etc. etc. until pretty soon they lose their supply or give up in agonised despair.

For the first few weeks milk production is driven hard by the pituatry gland AND by the stimulation at the breast (which is why most people have masses for those early weeks then it tailors to bubs need) and generally shield use during that time won't have too much impact, but past 4 or 5 weeks supply begins to tailor just to demand so it's good if bubs can be attaching themselves by then.

If i were you Gracie i'd get a LC to come out to you and have her help you practice the attachment without the shield, but hang onto it so you can always use it if you need to when she isn't there. I do know a woman whose little girl just couldn't get to grips with it and she used shields until her DD was six weeks old, by which point her mouth was bigger and she could feed without injuring her long-suffering mum. This did her no long-term harm and the mum was able to BF for as long as she wanted to.

Don't feel disheartened Gracie, every day is a year in terms of learning for bubs - you'd be amazed at the difference even another week of practice at this living, breathing, sucking lark can have. You're doing a great job, hang in there.

Bx

[black_rose]

I have used one up until this week (12 weeks) for for the left and for about 3 on the right as Adele was a prem and my boobs are huge so she was unable to breath when she latched on properly. She let me know when she no longer needed it on both sides, and she is now able to feed successfully on both sides.

I was advised by the hospital to express after using the sheild though to maintain my supply.

[Barb Glare]

Hi, Gracie,

Babies are born to breastfeed, and in a normal, uncomplicated birth they should go to the breast within the first hour after birth. Like all baby animals, they "imprint" in these early feeds. You want them to imprint the normal way of sucking - not imprint a silicone nipple shield. But, like all things, feeding sometimes doesn't go according to plan, for a number of reasons, and in this case, nipple shields can be a useful tool to help you overcome a problem. They are best used with the support of a trained LC or breastfeeding counsellor.
Your baby is acting like a normal 1 week and four day old baby. Babies LOVE to be with mum - you are everything to her - food, comfort, warmth, a familiar voice and smell to help her transition from the womb into the world. She needs her mummy. Sucking feels so soothing and fabulous to her - she would love to be there all day! Baby heaven!
You will probably notice that at the start of a feed she sucks quite vigorously, but by the end of a feed she is snoozing for quite long periods between "butterfly sucks" Yet, confusingly, if you detach her she makes a garb back for the boob as though to say "no, mum, honestly, I'm feeding still!" However, we also know that they get the biggest quantity of milk in say, the first 10 mins after your milk lets down. Breastfeeding for a really long time is great, and there will be times during the day when you have the soapies on and you are snuggled up on the couch with your darling - it's fine to just feed and feed. Other times you might want to shorten it a bit. Because having these really, really long feeds can mean they actually have fewer feeds in 24 hrs. So, sometimes mums find it works for them if they feed from one breast for, say 20 mins, give baby a burp, nappy change, and offer the other breast. She may not want it at all. Or she may just want a few sucks. You may find too, that, when she has had a good long feed you can start to develop some other settling techniques, apart from breastfeeding, to get her to sleep. Often wrapping her tightly (swaddling) and cuddling her or rocking her will recreate those womb like sensations she find so comforting.
Does your little one attach without the nipple shield? YOu might try her straight on the breast for a few feeds - see how it goes. If it is going well, try a few more feeds just on the breast. But the important thing is that you relax, enjoy feeding that she gets plenty of milk to grow. Warm Regards
barb

[Ginger]

thanks for all your help everyone. i have been trying a couple of feeds a day without the shield and sometimes it works, sometimes it doesn't. he just seems to attatch so much easier with it on. the other thing i have been doing is using it for the first few minutes until the nipple is sucked out and then unattatching him, taking the shield off and reattatching him. this seems to work ok. i think he just likes long feeds? it is driving me a it crazy though. he seems to spend so much time on my boobs, and when he's not asleep he seems to be crying and unsettled. he's also got really bad wind and diarreaha. he has so many wet nappies i can hardly keep up...i am going to see the child maternal health nurse this afternoon so i will be asking her for some help and she will be weighing him so i'm really really hoping he's put on some more weight. i really don't want to switch to ff..

[Janie]

Gracie, pop back in and let us know how you go with your MCHN. I don't see any reason ATM why you would need to switch to FF, so don't worry about that. You're doing a great job hun, and the fact that he can attach after the nipple is drawn out is fantastic! Just a thought, can you physically draw the nipple out by hand expressing a little before attaching him? I'm sure someone's already shown you this, so sorry for repeating it!

[Barb Glare]

Hi,

You really are doing a fabulous job! That diarrhea is not diarrhea - diarrhea is virtually unknown in a fully breastfed baby that age. It is normal baby poo. It's usually extremely plentiful, runny, yellowy, mustardy, smooth or seedy. I think when you have been to the health centre you will find your baby is putting on plenty of weight! If that's the case - time to do the crash course in settling techniques, and understanding baby's sleep patterns. As I said before - they love being with mum, and hate being separated from her, but slowly, they will learn to sleep by themselves
Regards
Barb

[~Raven~]

I second Barb on the poo! Completely normal for a breastfed bub to have very runny watery poo. All 3 boys of mine have been exactly the same in that department

[Junglemum]

Gracie, Luella pooed when i changed her nappy last night and it squirted off the changetable, down my front, on the carpet and everything else in a 1m radius! It was like a water pistol. (Why does this only happen at 3am???? ROFL)
Every nappy change, about every 3 hrs, she generally has a wet nappy with squirty poop. And how does it get chunks in it anyway? It's only milk?! Another newborn mystery!
Hope your appointment goes well Gracie. xx

[~Raven~]

The little lumps would be fat from the milk!
ROFL at the little water pistol

[Janie]

OT, Gracie where do you live in the hills? I grew up in Kallista, and have ILs scattered around

[Ginger]

thanks everyone! i think dp is stressing me out saying he shouldn't have diarrea he must be sick. he just doesn't want to admit that all this farting is inherited from him!
lmao ange at getting squirted. think yourself lucky you don't have a boy. i get p88sed at every time i change his nappy- all over the wall, everywhere!i'm changing his nappy every 1-2 hours at the moment.
sezjm- i live in kalorama- near kallista!but on the other side of the mountain

barb- can i please ask you...should i be feeding from both boobs each time i feed? sometimes i just like to use one and then use the next one the next feed.is this ok?
i didn't get to feed ds until a couple of hours after he was born as i went into shock after the birth and was shaking uncontrollably and throwing up all over myself. i was hooked up to a drip and then fell asleep for a while. dp held ds the whole time until i woke.

[Ginger]

good news everyone. just got back from the health nurse and ds has put on 90grams since friday!
she's really happy with that and happy for me to keep on breastfeeding. yah!
i'm going back again next wednesday to see what his weight is then, but at the moment i just have to keep perservering with the breastfeeding!

[Barb Glare]

Hi,
Well done! You know, ABA had to actually put out a "poo chart" because so many people in Australia have so little understanding of what is normal for a baby (like your dp) that we had to make a chart with coloured pictures and simple instructions of what poo is like!
Your baby will take more milk if you give him 20mins or so on one breast, detach him if he doesn't come off himself, burp him, change his nappy and then offer him the other side. Give it a try and see what you think. When you feed him on one breast for an hour he is getting lots of comfort and bonding, which is great, but not so much milk
Warm Regards
Barb