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Women’s Health Matters

Breastfeeding Using a Nipple Shield

Usually nipple shields are temporary. They are used until your baby can learn to feed at the breast alone.

What a nipple shield does:

Helps the baby grasp the nipple

The shield can help your baby stay at the breast without working so hard. (It is like using a gripper, or towel to open a jar: it helps the baby hold on to the breast more securely.)

Helps the baby feel the nipple

Babies who have had tubes during the early weeks and have been sucking on firm pacifiers have a hard time recognizing a soft breast nipple.

Helps the baby fit the nipple in his mouth

Premature and small infants have small mouths. Some cannot yet open their mouths widely enough. For some babies, a nipple shield will almost extend the nipple so the baby can draw the nipple in further.

Helps the baby get more milk at the breast

One study demonstrated that premature infants got three times as much milk when they used a nipple shield and used them for only about a quarter of the total months that they breastfed.

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 Shields come in 3 sizes

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Problems with nipple shields

Slipping off the nipple shield

A nipple shield can interfere with breastfeeding if it is not well on the breast and the infant does not take the tip of it deep into his mouth. If this happens you will see more of the shield, and it will draw in and out during feeding.

Low milk supply

If the infant is not able to draw out enough milk to grow on and is sucking lightly with the shield, the supply will probably lower. In this case, pumping after the baby goes to the breast would probably keep the supply from going down while you fix the sucking behavior.

Sore nipples

If the baby just chews with the nipple shield, you can experience painful nipples. A good latch means that the tip of your nipple is not pinched by the baby.

Weaning from the nipple shield

Nipple shields are like trainer devices; their use is temporary.

When to wean from the shield

Many premature babies need a shield until they are at least 40 weeks gestation or weigh about 5 pounds (or 2.25 Kilos).

 

 

 

Nipple shield in place with nipple in the tip Center the shield on your nipple with as much nipple as possible of it inside the tip of the shield.

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How often to try breastfeeding without the shield

If breastfeeding is going well with the shield, try not using the nipple shield once a day you go home. Pick a time when you are comfortable and baby is awake but not yet frantic. If the baby does well, try more sessions without the shield. You may want to check that the baby is gaining weight before stopping use of the shield.

How to tell if the baby is getting enough milk without the shield

If the baby was breastfeeding well with the shield and you stop using it and breastfeeding is going well, baby will be content after feedings and your breasts will not feel fuller. If they are suddenly fuller after stopping the shield, then baby is probably not getting as much as he/she did with the shield. Perhaps partial feeding with the shield would be necessary for a while.

How to breastfeed without the shield

Remember, the latch is very important. Baby should face you with the nose close to the nipple (this helps baby learn to tilt the head up and open the mouth).

Help baby learn to open wide

Baby needs to open his/her mouth very wide. Help the baby practice opening wide by massaging the lips a little several times a day. If you use a pacifier, touch it to his/her lips first and wait until the mouth opens before giving it to him/her.

Help baby learn to use the tongue

With the baby at the breast, wait until the baby sticks the tongue out instead of pulling on the chin to open his/her mouth. Placing a few drops of your milk on your nipple may help the baby begin to explore with the tongue.

Encourage the baby softly

Some babies get frustrated when they don’t feel the plastic in their mouth immediately or smell your milk. A calm voice reassuring the baby may help encourage him/her to keep trying. A few seconds may seem like a long time, but be patient. On the other hand, avoid letting the baby get too upset. As babies grow they get bigger and stronger and more able to learn how to breastfeed efficiently.

Seek help if you are having difficulty with discontinuing the nipple shield

Lactation consultants in your community can be a resource in helping you with breastfeeding. Most infants go home still needing to learn a little more about breastfeeding. Keep phone numbers of resources close by!

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Notes:

Find a Doctor: (800) 444-2559 • Patient Education Library: www.ucsfhealth.org/education

Women’s Health Matters