Ugh. That’s pretty much the summation of what most moms have to say about that dreaded piece of plastic called contact nipple shield. Majority of nursing mothers have not had to resort to using this little tool, and thus do not simultaneously curse and praise it’s existence. For those of us who have had to rely on it, it’s a total pain and nuisance: they’re never clean when you need to feed your baby, they will not stick to your breast unless wet and using both hands to put it on, and trying to discretely put one on in public while simultaneously wrangling your crying hungry infant is a whole new definitions of “fun”. Don’t even get me started on forgetting to take it off after a middle of the night feeding and waking up in a pool of your milk. Believe me, it’s not nearly as glamorous as Cleopatra’s milk baths may lead you to believe.
But despite their obvious annoyances, they have also been a gift without which we might not have been able to breastfeed with Alice. To be honest, I hadn’t heard of shields until Ali had trouble latching in the hospital. Despite my detailed research on breastfeeding and breast pumps and accessories leading up to her birth, there was never a mention of contact nipple shields in the countless “must have breastfeeding accessories” lists I read on forums and blogs.
Now, 15 months after the fact, there is a LOT I can say about our nursing attempts in the hospital, not the least of which is that a. Alice was never checked for a tongue or lip tie while we were in the delivery wing, b. the hospital lactation consultant (LC) took all of 2 minutes with us before introducing the shield to my 12 hour old baby, and c. no follow up on breastfeeding was set up for us. Hindsight is 20/20 and I understand that ONE hospital LC has a caseload of all the new moms and only has a few minutes to spend with each of us, but I wish I had advocated for better care and support at the start of our breastfeeding journey. It wasn’t until Ali was a month old and we had our WIC certification that they offered we see their LC one-on-one. By this point, my little nursling was very much set in her ways, and even as we kept trying to work past the oral issues until 2 months, and then chose to treat the oral issues with scissors, the procedure did not stick and she has never nursed off the shield. I could have done better for both of us but I just didn’t know. But this post is not about blame. This is about shields.
At the hospital we were given the Medela* shield, 20mm (size Medium). The LC showed me how to put it on, put a few drops of sugar water on it to indicate to Alice that it was where food comes from and latched her on. While she latched and nursed, she slipped off frequently and her feedings were very interrupted. The nurse then recommended we get the 24mm (size L) shield, but ultimately it was the same story. Two days later once we were settling in at home, my mom called from Walmart telling me there was another brand of shields and asking if I wanted them. At that point I was going to try ANYTHING to keep Ali well latched. It turned out the shields my mom got were Lansinoh* 24mm, and once we tried them she stayed latched on for the duration of her feeding. MAGIC!!
Here’s what I think happened – the Medela shields have a kind of conical shape, and thus I think it was difficult for her to stay on it in the early days. Whereas the Lansinoh ones are a bit more curved along the body and rounded at the tip, giving more area for her to hold on to. Other brands I have looked at (but not tried) were Avent* and Tommy Tippee*, but they too seemed to mimic the conical shape of Medela.
So here are a few tips and things to consider with using shields:
- It’s a common concern with moms that long term use of shields will not allow for adequate breast stimulation and thus can lower your supply overtime. While this is rarely the case, every mom-baby combo is different. Rushing to wean baby off the shield before he or she is ready can cause more problems for you both: there are moms who breastfeed with shields well past baby’s first year and moms who wean off them within the first few days or weeks of use. You may fall somewhere in between.
- When attempting to wean, it is recommended that you try it when baby is most relaxed, and not when he or she is hungry (or hangry!). Best to try taking away the shield in the middle of the feeding, when offering the second breast. Alternatively, you can try taking a bath with baby and offering your breast sans shield. If he or she is calm and relaxed you may find they will latch. However, something to consider here – latching on without the shield is only part of the process. You also want to ensure baby is able to express enough milk for themselves while staying latched. This may be difficult for babies with significant tongue and/or lip ties, as well as those with very high palates. See your pediatrician and LC for diagnosis and recommended treatment of these conditions.
- Finding a shield that works best for you and baby may take a bit of trial and error, (and thus can get a bit pricey). This is not just about the shape of the shield but also the size. Some LC providers may offer you one free of charge or may be able to recommend the best shape/size for your particular situation.
- You want to wash the shields with warm water and a bit of dish soap after every feeding (make sure to rinse thoroughly) and sterilize in sterilization bags once a week. Keep them in a clean container near your nursing area and always keep a spare set in your diaper bag or car. If your baby only eats with shields, you don’t want to be caught without them on the go… trust me…
- Getting them to stick on well requires them to be clean and dry. Ensure there is no soapy residue and minimal water spots or calcifications.
- The shields are quite durable but may require replacements with long term use.
Don’t be discouraged if you find yourself needing to use nipple shields – you are not a bad or failing mother, you are just having to get a bit more creative about nursing your little one. However, shields can be a band-aid-for-a-bullet-hole type of solution for certain cases so I highly recommend seeing a lactation consultant to get to the root of the problem. It may be that between yours and baby’s anatomy, shields are your only nursing option. Or they may be a very temporary nuisance in your overall breastfeeding journey. Reach out, ask for support! Your OB-GYN may work in partnership with a lactation consultant, your local WIC office has them on staff, and if you don’t have access to one through either option, reach out to a local La Leche League group. They are a fantastic breastfeeding resource!
Good luck, mamas!!
*Please note: I am not compensated to endorse or critique any of the aforementioned brands, products, or support groups. These are simply my personal opinions and experiences, and are not meant to diagnose, treat, or help/worsen any medical or physiological condition.