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Evidence-Based | Breastfeeding Information | For Families

Tricky Tools
Like all tools designed for use during lactation, nipple shields can be helpful or harmful. However, there are some very signicant risks to baby's health and to milk supply if nipple shields are used improperly.

A False Sense of Security

Keep in mind that if a baby is latching to a nipple shield, it is not the same as latching on the breast. The baby does not use the same sucking mechanics, and the breast does not receive the same hormonal and mechanical signals from the baby.

Nipple Shields
Nipple shields are thin, round pieces of silicone shaped to t over a mother's nipple. They are not nipples are meant to be used on bottles, and they are not meant to be used indenitely. Some mothers use nipple shields under the guidance of their IBCLC as part of a complete Breastfeeding Management Plan. Using them without trained, careful guidance may lead to signicant breastfeeding problems. !

Nipple Shields May Seem Like the Perfect Solution!

If you are thinking about using a shield, or if you used one with a previous baby, you should talk to an IBCLC before introducing one to your new baby. You should receive thorough information about how to use a shield e"ectively and safely as well as how to get your baby back to breastfeeding without the barrier. A nipple shield that you purchase will not come with those instructions. 1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014757/? report=classic

Is There Evidence to Support Their Use?

A systematic review of the existing evidence revealed that the commonly-held justications for using shields does NOT support their use in most situations.
1. McKechnie & Eglash, 2010.

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Quick Guides

What Kinds of Problems Are Associated with Nipple Shields?

One of the riskiest times to use a nipple shield is during the rst days of baby's life, when milk ow has not been established. During this time, baby should have direct contact with the breast as frequently as possible to maximize mom's hormone response. Babies frequently cannot transfer the rst milk (colostrum) through a shield easily because it is thick and does not ow easily. Many babies are happy to suckle on a shield even when they are not getting any milk.
An improperly placed shield

Many healthcare professionals believe that nipple shields are harmless and o"er them in an attempt to "rescue" breastfeeding. Unfortunately, the evidence does not support that outcome. The evidence shows that most mothers who use a shield wean at the same time or earlier than those who do not. There are, of course, exceptions, but the bottom line is that healthcare professionals are obligated to provide evidence#based information, and the evidence does not support the use of nipple shields in all situations. A baby who cannot latch or transfer milk may need to be fed using a spoon, cup, or bottle and then receive continuing help from a trained lactation professional to ensure baby can resume feeding at the breast.

The biggest risk associated with nipple shield use is baby not receiving enough milk. Since this takes time to show itself, and since babies sometimes give no outward signals that they are not feeding well, babies can lose a lot of weight while using a shield if they are not receiving proper follow-up care including frequent weight checks.

can cause nipple damage

A shield used because mother

has nipple damage or soreness does not address the source of the problem
A baby breastfeeding with a

shield in place may not thoroughly remove all the available milk from the breast, one of the cornerstones of maintaining milk supply

If a baby is not latching, begin expressing milk by hand and/or with a pump, keep the baby fed, and refer to an IBCLC as soon as possible.
may be reproduced in its entirety with copyright intact

copyright 2013 bakerseld breastfeeds