Let’s talk about nipple shields
Let’s talk Nipple Shields!
Did you know they are generally supposed to be a temporary measure and a short term tool to help you.
Nipple shields are great for a variety of reasons and here are a couple.
1 - Nipple Damage - Nipple damage is usually because of a bad latch in the early days while everyone is still learning and working it all out. But the baby could also have a tongue tie. If we have damage, the first thing we want to do is really check that the latch is the deep enough. Roll the baby back and if they fall off easily they usually aren’t on deep enough.
If the baby has a tie this needs to be assessed and either cut or given exercises to help if it is minor.
But nipple shields can protect Mum while this is being worked out. In the case of minor damage, regular silicone nipple shields are best. In the case of major damage (I’m talking cracked / bleeding / mum can’t stand the though of a baby on her), Haaka have what I call the Def-Con five of nipple shields, that help to protect breastfeeding, while giving mum time to heal and not have the baby on directly touching skin. This style should only be used in extreme circumstances as we don’t want to develop a bottle preference in a baby if we are trying to maintain and protect breastfeeding.
2 - Inverted and Flat Nipples - Mums with inverted or flat nipples can find nipple shields help to draw out the nipple and for a lot of Mums this issue usually resolves itself with repeated breastfeeding as the nipples “learn” be more out!
Flat nipples can also happen as a results of epidurals. When you have an epidural, IV fluids are given. These fluids look for a way to leave the body and tend to go to the lowest hanging extremities - Hands, feet and breasts. Artificially inflating them and making it harder for the baby to get on. In the case of flat nipples, you can also try pump for a couple of minutes before the feed to draw your nipple down and out and then pop them on.
3 - Bottle Back to Breast - A baby who has been exclusively bottle fed and is learning to transition back to the breast. Nipple shields can be a good interim transition measure.
4 - Disorganised Suck - This is a baby that may have been effected by a traumatic birth, pain relief drugs in labour, or who can’t quite coordinate the process of latching and the pattern of suck swallow breathe, falls asleep and is generally disorganised. Again a nipple shield can be a temporary measure to help the baby get going and protect the nipple from damage.
So why are they temporary?
The biggest reason is because nipple shields can reduce your milk supply. They can slow the flow of milk and they are generally quite annoying and fiddly.
Babies need to stimulate the breast to adequately increase supply.
Germs also flow backwards from a baby to Mum helping her milk to change to help provide antibodies to help the baby combat their illnesses. Cool huh!
Case Study - A lovely Mum recently asked me for help with her supply and a few concerns she had about her feeding and it came up that she was using shields. Her baby is 9 weeks old. They were given to her after the birth for a disorganised suck but she was never told to only use them temporarily. When using shields, there should always be a plan for getting away from them but if you aren’t told that, you don’t know.
Getting back to breast - Not impossible! But will require a little effort. Start with as much skin to skin as possible. Lock yourself in for a few days and for every feed offer the breast without a shield. The baby may fuss and carry on but try to be persistent for a few minutes. If you can’t get them to take it, put the shield on and feed. Remember - Feeding the baby is key, we just want to give them maximum opportunity to try. Try feed without the shield when they are hungriest, usually the first feeds of the day.
Another option is to try the old bait and switch! Start them on the shield and then whip it off after a couple of minutes! Persistence and practice are key. The Mum in the case study above did it, took a couple of days.
Another option is to initially offer them a clean finger to suck on, once they get organised into a good sucking rhythm on the finger, you could swap it out for the breast.
I get asked in my class if they should be bought before the birth. Generally my answer to that is no. Don’t get me wrong, nipple shields are fantastic if things are going wrong, but I hate assuming that things won’t work from the start! Plus they usually hand them out in hospital if they are needed.
To learn about shields, pumping, how much your baby needs to feed, cluster feeding, the newborn days and beyond and so much more, join my LATCH breastfeeding class, group class held monthly in person on the Northern Beaches, or book a private in home session or watch the online version anywhere, anytime.
https://www.beachesbaby.com.au/latch-breastfeeding-education
