Breastfeeding nipple shield info

Support for Using Nipple Shields Posted on February 27, 2013 by bfcpgh By Wendy Eson A nipple shield is a thin piece of flexible silicone designed to help a baby who is having trouble latching onto the breast. It is worn over the mother’s nipple during breastfeeding. It is important to assess the need for a shield on an individual basis. Nipple shields are not considered a routine part of breastfeeding and are to be used under the supervision of a lactation consultant. Ideally, they are for short-term use. In addition, they are often helpful in getting a baby back to breast after the introduction of bottle-feeding. They are not designed for nipple pain. BREASTFEEDING SITUATIONS WHERE A SHIELD MAY BE HELPFUL •A baby who is born preterm or late preterm, which is 34-37 weeks gestation. These babies often have trouble with latching at the breast and can tire easily during feeds. There is evidence that nipple shields help these babies keep more active at the breast. •A mother with flat or truly inverted nipples. Caution should be used in determining flat nipples. A good majority of new mothers have some fluid retention in their breasts shortly after giving birth. This is especially true for a mother that has received a lot of IV fluids in labor or certain medications. Nipples in these mothers often appear “flat” due to retained tissue fluid. The areola is also firm, making it difficult for a baby to latch. Mothers should be taught to soften the areola by compressing it with the fingers (Check out this link on Reverse Pressure Softening). This helps move fluids back toward the chest wall and softens the areola. It also draws the nipple out, making latch easier for baby. Mothers can also be shown how to form the end of the breast into a wedge or a “breast sandwich.” This helps baby take in more of the areolar tissue, ensuring a good deep latch at the breast. •A baby who has become accustomed to the firm texture of a bottle nipple. In this instance, a shield can be a good tool in getting baby back to breast. •Rarely, a shield can be used for sore nipples. Once latch has been reviewed and corrected and other issues have been ruled out, a mother with sore, cracked nipples may benefit from a shield as nipples are healing. Having a baby at the breast with a nipple shield is better than not having a baby at the breast, however the shield must be used correctly. Mother’s should observe for good urine and stool output and appropriate weight gain. If this is in order, mother can be assured that baby is effectively transferring milk from the breast. Mother’s should be taught to observe for a good latch with a shield. The baby’s lips should be well flanged, with chin in deep to the breast. If baby is just on the tip of the shield, causing the shield to indent around the nipple, baby may get less milk. Additionally, mothers need to watch for clogged ducts, as the shield can cause reduced milk transfer. A mother whose breasts still feel full after feeding with a nipple shield may consider pumping afterwards to effectively empty to the breast. HOW TO WEAN BABY FROM A NIPPLE SHIELD By definition, to wean from something is to detach from gradually. A mother should allow herself and baby several weeks to come off the nipple shield. Here are some helpful tips: •Always ensure proper latch, bring baby in close and wait for a wide open gape. •With your index finger and thumb, compress the area around the areola to make a breast sandwich or wedge. This makes the nipple firm. Once baby is brought on deep, hold the sandwich until you feel baby suckling well. •Consider pumping to elicit let-down, providing baby with a quick reward. Pumping also helps to elongate the nipple. •Feed baby when somewhat sleepy and not too hungry. They are often easier to put to breast and willing to nurse. •Try latching baby with shield and removing it once let-down has happened. Swiftly place baby back at breast. This “bait and switch” may take several attempts. If baby becomes frustrated with this, allow him to nurse with the shield. The goal is to have a happy baby at the breast. •If it is easier to latch baby at breast with the shield for nighttime feeds, aim for removing it during some of the daytime feeds. DO NOT CUT OFF THE TIP OF THE NIPPLE SHIELD! THIS MAKES FOR SHARP EDGES AND CAN HURT THE BABY. Be patient with yourself and baby as you wean from the shield. Enjoy the time when baby is at the breast and commend yourself for giving your baby the benefits of breast milk!