Breastfeeding Moms and Nipple Shields
By Tamar Krantman Weiss
Remember rubbing (or more likely scratching) your tummy, daydreaming about what life would be like when the baby finally arrived? First-time mothers planning to breastfeed probably spend a good deal of time wondering what sort of an experience breastfeeding will be and whether it will go smoothly, and hoping that it will result in a special bond between mother and child. Breastfeeding often does go very smoothly, but sometimes there are unforeseen difficulties, most of which can be worked out. Any woman faced with sore or inverted nipples or a baby having a hard time latching on can attest to some challenging periods. When faced with such situations, some women may opt to use what are known as nipple shields.
Nipple shields are synthetic nipples generally made of silicon, similar in appearance to bottle nipples. A women places them directly upon her own nipple in order to theoretically facilitate an easier time breastfeeding. The shields have protruding nipples so that they make latching on relatively easy, and because they are superimposed upon the natural nipple, they may relieve some of the pain from sore nipples. Frequently, though, the nipple shields are used for problems that can be corrected without them.
Nipple shields are synthetic nipples generally made of silicon, similar in appearance to bottle nipples.
Dr. Deena Zimmerman, a pediatrician and international board certified lactation consultant (IBCLC), points out that although the use of nipple shields is warranted in certain circumstances, these are “few and far between.” They may be recommended for a woman with terribly sore and cracked nipples, but should be used for a short period of time. In such a case, the shields act as a Band-Aid, “they are not a panacea,” and do not correct the root of the problem which is most likely, she says, a problem of positioning with the baby.
Dr. Zimmerman finds that nipple shields are also frequently suggested to women who have flat or inverted nipples and this is likely inappropriate; in her experience, most babies can latch on without the use of such devices. “After all” she notes, nursing “is called breastfeeding, not nipple feeding.” According to Dr. Zimmerman, it’s possible for a woman with flat or inverted nipples to have a very positive and natural breastfeeding experience. If nursing alone does not draw the nipple out, Dr. Zimmerman suggests that a woman can use a breast pump or other alternative suggested by a lactation consultant. As a general rule, “nipple shields should only be used in concert with aid from a lactation consultant or other professional who can correct the underlying difficulty.”
Zimmerman stresses that although nipple shields may seem like a welcome solution to mothers who are having difficulty nursing for whatever reason, it is crucial to use them sparingly. In the event that they are overused, the drawbacks of using nipple shields will most likely outweigh the benefits. One recognized problem with the shields is that they cause the mother to receive less stimulation, the baby to receive less milk, and thus can diminish the mother’s milk supply and the baby’s weight gain.
Another common problem with the use of nipple shields is that it may result in nipple confusion. The shields, says Dr. Zimmerman, teach the baby to suck from an imitation nipple which he or she will become used to and may then refuse the real thing.
Zimmerman maintains that whatever the factors are that result in the use of nipple shields, it is of utmost importance for a breastfeeding mother to persistently try to feed the baby without the shields at regular intervals. A good time to try nursing without the shields is when the baby is “interested [in eating] but not hungry, and certainly not when the baby is starving.” Many women trying to wean their babies from nipple shields successfully begin a feeding session with the shields on and then slip them off in the middle, managing to put the baby directly to the breast. Whatever the method, the important thing is to not give up trying to breastfeed without nipple shields.
Abbi is the mother of a baby girl who was born very small and lacking energy. Due to the baby’s condition at birth, Abbi was not permitted to nurse the baby immediately as she had planned. When given the opportunity for their first nursing session later, both Abbi and her baby had a hard time.
She was wrongly advised in the way to position herself and the baby and soon they found themselves in a frustrating cycle: the baby was tired from not getting enough nourishment, she would take one suck and fall asleep at the breast, and then become continuously hungrier and more exhausted. Finally a lactation consultant gave Abbi a few options to consider, one of which was nipple shields.
At first Abbi was happy with the shields because her baby was actually sucking and receiving well needed nourishment, which to Abbi, was the most important thing. She was disheartened, though, when she tried to feed the baby without the shields and the baby refused her, whereupon Abbi turned to a breastfeeding expert for help. It was suggested that Abbi make the four small holes in each shield in to one larger hole, creating a more authentic feel for the baby when the milk would be released.
Abbi was also told to progressively shave off small amounts of the silicon on the nipple shields, thus over time exposing her daughter to larger amounts of the natural nipple so that the baby would become more comfortable with it. Although she found this to be physically painful, (silicon can be sharp, where rubber nipple shields are easier to cut back) Abbi persevered. At the age of 4 months her daughter was successfully weaned from the shields.
Abbi notes that the entire ordeal was “extremely trying, both physically and emotionally,” but her end results were very positive. She was, however, rather upset with the feedback that she received from various nursing mothers and others who made her feel inadequate by using the nipple shields. She affirms that she and her daughter have a very close bond and a few months of “using a piece of silicon did nothing to hinder that.”
Like Dr. Zimmerman suggests, Abbi continually encouraged her daughter to nurse without the use of the shields, and of great significance, enlisted the help of professional lactation consultants. As Dr. Zimmerman emphasizes, so much of the time, difficulty with breastfeeding can be solved with learning to properly position oneself and the baby.
Before finding herself in a difficult situation of overusing nipple shields or trying to wean a baby off of them, a woman should be sure that her particular situation warrants their use to begin with. Of equal importance, a woman already using the shields should not give up hope that her baby can and will be weaned from them. If a mother continues to encourage and offer her natural breast to her baby, the effort is likely to pay off in a natural and rewarding breastfeeding experience.