Originally posted 2/1/2016; updated 7/12/2020
I have a theory about nipple shield distribution, and it’s based on the large number of families I see who are struggling to ditch the shield.
I always ask how the family got the shield in the first place, and the story is usually the same: the nipple shield was introduced in the middle of the night by a nurse who may or may not have been a lactation consultant.
I have a mental image of someone pushing a cart down the halls of the postpartum ward, flinging nipple shields like frisbees into every room at the stroke of midnight.
(Yes, I know this is not the case. I love me some nurses. No hate mail please.)
I am updating this blog post during the COVID-19 pandemic and many, many more parents are being given nipple shields (or as the local hospital call them, “nipple guards” or “breast shields”) soon after birth in hopes that the baby will begin to breastfeed faster. The sooner you can say the baby is latching, the sooner that baby will be cleared to go home. Sometimes parents are handed a shield while still in labor & delivery because someone looked at them bare-chested and said “you have flat nipples, you’re going to need this.”
Nipple shields are a tool, and they can be a massive help to nursing families. Often times they allow baby to continue breastfeeding in situations where nipple damage, pain, or poor latch could lead to a parent giving up on nursing altogether.
They’re certainly not a new invention; nipple shields have been around in various forms for hundreds of years. I have no doubt that today’s silicone shields are leaps and bounds better than the lead, glass, and rubber shields of the past.
The Medela Contact Nipple Shield that most of my clients get in the hospital
The Mamivac Cherry Nipple Shield, seen on the right, is often recommended by IBCLCs due to its unique “cherry” nipple shape
But nipple shields are fiddly and inconvenient, and they can be messy and frustrating to use. They can also be difficult to wean baby from; the shape and structure of a shield can make it easier for baby to stay latched and once a baby is used to a shield they often don’t want to nurse without it.
So what steps should you take when you’re trying to ditch the nipple shield?
Before you start this process, it’s really important to know that weaning from the nipple shield takes time and patience. The process may be two steps forward, one step back for a while.
Best case scenario, you can totally ditch the shield within 2 weeks- but I’ve seen it take a month or more. Patience is your best friend here.
The other factor to be aware of before you start is that the shield may be masking latch or anatomical issues that still need to be addressed.
A nipple shield doesn’t fix anything- whatever problems you had that caused you to start using the shield may still exist.
If you start to have success latching baby without the shield but you are experiencing pain or nipple damage, GO BACK TO THE SHIELD and call me or another IBCLC for help.
The baby in this picture does NOT have a good latch. Heck, I don’t think this baby is even eating. She looks really confused.
This is a 10 tip-step-process hybrid: mostly in chronological order but not all steps/tips will apply to all people. Please read the whole list first and decide which tips apply to your family before you begin!
1. Do as much skin-to-skin as possible, even when baby isn’t eating. This helps to re-wire baby’s brain and can help them latch without the shield. Skin-to-skin can make a BIG difference in getting baby to latch.
2. Watch your sleeping baby for early hunger cues (rapid eye movement, fidgeting or wiggling, etc) and try latching them when they’re just barely awake. You can even try latching them when they’re practically still asleep.
3. Nurse baby often- every 2 hours or more, at each hunger cue- because babies with empty bellies are very impatient and may refuse to even try latching without a shield. You cannot nurse a baby too often, and you can’t spoil a baby. When you’re working on ditching the nipple shield just consider yourself an all-day buffet.
4. Do not allow baby to get too upset while trying to latch to the bare breast. If baby begins to complain loudly or cry, use the shield and try again later. You do NOT want baby to associate your bare breast with being uncomfortable or upset! Think about it- can YOU learn new skills when you’re yelly and hangry?
5. Hand-express a few drops of milk onto your nipple before trying to latch to entice baby. If you are using formula you can do the same with a drop or two of formula.
6. Talk gently to baby and encourage her/him. They’re used to hearing your voice from their time in-utero, and the sound of it is comforting and soothing. Even if latching isn’t going well, continue using a positive tone. Tell your baby that they’re doing a good job, that you guys are a team and you’re going to do this together. It’s purely anecdotal but I have noticed that the moms I see who talk to their babies while they latch tend to be more successful at it!
7. Use your hand to shape your breast into more of a mouthful. Using your thumb, gently pull back on the skin above your areolae so that your nipple is tipping up towards the roof of your baby’s mouth (see below). Place your actual nipple right under your baby’s nose, and make sure their chin is firmly touching your breast underneath your areola. When baby opens their mouth they will need to come up & over your nipple- think Pez dispenser or Hungry Hungry Hippo.
8. If your nipples are inverted or very soft, there are different techniques to make your nipple more “shield shaped” and firm. Try:
- Pumping or using a Haakaa/silicone suction breast “pump” for a couple minutes before latching baby to evert your nipple
- Use an ice cube or a cold wash cloth to harden your nipple before attempting to latch
- Use a product like Supple Cups or Lansinoh LatchAssist to evert your nipples
9. On the other hand, if your breasts are engorged and too firm for baby to latch on to, use breast massage and hand expression or reverse pressure softening to soften your areolae. Babies need the area to have some give- otherwise it’s like a dog biting a basketball!
10. If baby refuses to even try to latch without the shield, try the bait and switch. Get baby eating with the shield and 3-4 minutes into the feeding, as his/her eyes begin to close, unlatch baby and remove the shield, then quickly try to latch baby without it. This can work like a charm if you do it fast!
Remember: if you or baby get upset, stop. Use the shield. Try again at the next feeding, or if you’re super frustrated, try again tomorrow. This can be a long process. If it was easy, you wouldn’t be reading this blog post, right?
Gift yourself with some grace. Imagine me (literally) patting you on the back. This breastfeeding thing is not for wimps. You’re doing a great job.
And if you have success with my tips, please come back and let me know!
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