Guidelines for Using a Nipple Shield

A nipple shield might be used when your baby is:

• Unable to latch well due to you having inverted nipples or firm areolas

• Unable to latch well due to restricted tongue motion

• Born prematurely

  • a nipple shield helps premature infants get more milk

  • decreases the amount of work and energy needed during breastfeeding, allowing baby to complete a full feed

• Transitioning from bottle feeding to breastfeeding

A nipple shield might be used when you have:

• Cracked nipples or severe nipple pain with breastfeeding

• A fast let-down that your baby has difficulty controlling

Disadvantages to using a nipple shield:

• Full term infants learn to suck differently with a nipple shield and may have difficulty weaning from the nipple shield

• Baby may get less milk if nipple shield is used incorrectly and/or is the wrong size

• Possible low milk supply if breasts aren’t emptied well

• Mother is at higher risk for plugged ducts and mastitis

• Need to pump and hand express after each feeding until milk supply is well established and baby is transferring adequate amounts of milk

Care of nipple shield:

• Wash in warm soapy water and rinse after each use

How to apply the nipple shield:

• Fold nipple shield back so it is at least halfway inside out

• Center nipple shield over nipple, making sure to maintain contact between the nipple shield and the breast

• Do not stretch the shield

• Place both pointer fingers on the sides of the nipple shield and slide them down nipple, gently pushing at the base of the nipple to “roll” the nipple shield down the breast

• Nipple shield should be suctioned to your breast

  • Areola (not just nipple) should be drawn into nipple shield, creating a seal

  • Areola must be seen in the nipple portion of the nipple shield

  • Areola may be wrinkled at the base

Tips:

• Before use, you can run nipple shield under warm water to make it more pliable

• Do not grab the tip of the nipple shield and pull to pop it out, as this may cause loss of suction

• If able, hand express breast milk into nipple shield once applied

• If using the nipple shield hurts, stop and reapply nipple shield

  • If pain continues, stop using it and seek support from a lactation professional

You know the nipple shield is working for mom, when:

• Nipple pain is absent or improved

• Nipple portion of the nipple shield remains attached to the breast throughout the entire feeding

• Immediately after feeding:

  • moisture/colostrum/milk is seen inside the tip of the nipple shield

  • mom’s nipple is round, not wedged

  • areola is visible in the nipple portion of the nipple shield

  • breasts feel softer than at start of feeding

You know the nipple shield is working for baby, when:

• Baby’s mouth is wide open, and lips and chin are touching mom’s breast

• Baby is not sliding back and forth on the nipple shield

• After the first day of life, baby remains actively suckling for at least 15 minutes on the first breast and is content after feeding

  • You hear swallows with at least every 3-5 sucks by the end of day 3 or when supplementing at the breast with a feeding tube

How to know if your baby is getting enough milk:

Baby has appropriate number of feeds (minimum 8) per day

• Baby has appropriate number of wet and dirty diapers

• Baby has appropriate weight changes

Close follow up is recommended until your milk supply is well established. It is important to keep all follow-up appointments with your baby’s pediatrician.

Resources:

• Click Weblink: www.sharp.com

  • to find more information on our breastfeeding

  • postpartum support groups

  • the New Beginning’s Boutique

  • how to schedule an outpatient lactation consultation

Additional Resources for Pregnancy and childbirth:

• New Beginnings: (for postpartum mothers) 
  Click this weblink: New Beginnings