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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My baby does latch. However after a few seconds sucking she spits it out and can’t seem to find my nipple. Like she has lost it. Then she slams her head into my boob and gets mad. She is now almost 4 weeks. She latches well with the nipple shield. She has gone a few feeds without it. Sometimes half a feed but then she loses my nipple.
Thank you so much for this post, it gave me hope and after working with lactation specialist for a couple of sessions we found a way our baby would latch without nipple cover. We are getting more and more used to it, and have been feeding without it the past 3 days. My nipples are entirely flat, so I want to say to everyone else struggling: there is hope. Find good help that can look at your specific case. And stay strong 🙂
Really happy for you – amazing work !What way helped latch without nipple shield for you ? All help welcome
I’ve been exclusively using nipple shields since we left the hospital with my 3 week old. One of my nipples is inverted and my baby has a narrow latch. Her latch cause my nipples to crack and bleed so bad I contemplated stopping breastfeeding all together. We’ve stuck it out, but I’m getting tired of using a shield every time I nurse her. I’m also worried that she’s not getting enough to eat because milk keeps leaking from the bottom of the shield. Each time I try to get her to latch without, it’s like she doesn’t see/feel my nipple. I try the nose to nipple tactic and she just doesn’t open her mouth wide enough. Any tips on getting her to open wider?
Did you get a reply to this? It’s my same problem too.
Get the baby’s chin to touch first. Putting a nipple on or under their nose doesn’t help when their chin isn’t planted first. They need to come up & over the nipple!
Hi my names coby my baby 5 days old and was weak sucker. Im am trying so hard to get him off but my breast so big from over supply he cant get on nipple. I am feeling upset and frustrated as his my 5th baby and never had to use one before feel like im a failure.
My baby is 3 weeks old, I have been using the nipple shields since day 4, after we got back from the hospital, because my nipples were bleeding and were covered in scabs due to a very strong latch and too long nursing sessions in the hospital. I could not bare the pain. Now when I finally got the courage to stop using nipple shields my baby seems like she doesn’t know how to latch without it anymore.
My baby spent time being bottle fed in the NICU for his first few days. He wouldn’t take my breast without it. I was also told I had flat nipples. He’s only a week old and I’m hoping to wean him off the shield soon. Will be trying some of your tips!
My baby is 3 weeks old and has been using the shield for about 2 weeks now because my nipples were cracked and had scabs on them from a incorrect latch and i was not able to bare the pain. now my nipples are healed and i am trying to get her to latch again without the shield and am trying the ways you said but she just does not want to latch onto. Will i have to use the nipple shield forever if i can’t get her to calm down when i try to feed without it? the second she goes to the nipple and sees the shield isn’t there she gets frustrated and starts screaming and then it takes me a minute to get her to calm down to latch her back to the shield. 🙁
Hi Katlynn, if you can’t make it work without the shield its a really good idea to work with a lactation professional to help you both get the hang of it OR figure out what’s going wrong!
I’ve used them for over 18 months. My son had undiagnosed class 3 ties that he was suppose to have reversed last Thursday. We were out of town the week before last visiting family and it was hectic and he was fussy so I let him latch without the shield just to calm him down (I knew better bc last time he refused the shield, when he was 6 months old, my supply severely took a dip) and I was thinking, “I’ll just bare the pain since it’s only for another week.” Wrong!!!!! I got sick last week when we came back home and had to reschedule his revision for September. Now my supply has tanked. He refuses to nipple shield and bites it. So I’ve been letting him latch (if we can even call it that😢) and I’m in pain. He takes both breast now and goes between each one every 2 minutes and is frustrated. I know he’s almost 19 months old, but my goal is 3 and I’m not sure how to get him back on the shield for the next month until his surgery. I’m desperate for him to take it again. Any suggestions? I just need it one more month😭😭😭😭😭😭😭
Sounds like you need to work with a IBCLC who is skilled with older babies! I’m sorry things are so hard right now.
I’ve been using a nipple shield almost from birth onwards for my now 5 week old son. I have one flat and one inverted nipple, making it quite hard for him to latch on and nursing was so painful in the beginning. I cried just thinking of the next nursing session. The nipple shield worked really well for us, making nursing bearable and finally painless. He’s been gaining weight really well, no issues at all from that side. Now we are slowly training to wean off the shield, which is quite painful again and a slow and frustrating progress. Yesterday I finally managed to feed him almost exclusively without the shield (and without pain), which was a great success, but over night my breasts became engorged, almost as bad as when my milk first came in. Now I assume this has something to do with the feeding without the nipple shield? Does it mean my milk supply is increasing again? Do my breasts need to readjust? Will it go away after a few days by itself? And would pumping make it better or worse on the long term? I let my son drink as often as he wants, which is every 1.5-2 hours, but he doesn’t manage to empty the breast, which afterwards still feels quite hard and full.
Hi- this is a lot and not the kind of thing I can answer in a blog comment! Please consider booking a virtual visit with me: https://www.rachelobrienibclc.com/lactation-consultant-services-sudbury-ma/phone-and-virtual-consults/
I needed this. Thank you so much. Breastfeeding is so hard and I’ve lost so many nipple guards.
Also… I can’t believe it – you’re on the money!! Night midwife gave me my nipple guard…
Thank you so much for this info! The part about how most moms started using a nipple shield is exactly what happened to me AND I was given the incorrect size AND the nurse didn’t show the correct method to use a shield. I am now trying to wean my 10 week old off of it and your post was very helpful. She gets a bit agitated half way through, I think because the flow slows down but with the shield she doesn’t get agitated. Work in progress I guess.
This is exactly the same as my baby! He seems to get frustrated half way through a feed now I’m presuming because it’s harder work?? Any tips you’ve worked out?? Good luck lovely xx
Hi rachel , my son is 3.5 month old I tried alot nursing without nipple sheld but he always refused to drink . Sometime he latch without sheld but most of the time he refused without sheld . Can u plz suggest me some things coz I. So worried about him . I can’t feed him in any place coz sheld I need that .. plz suggest something.
I have flat nipples or perhaps just really short nipples. With both my daughters before I used a nipple shield. My first nursed for one year my second for nearly 3. Now with my son who is 2 months old I am using a shield once again and I really don’t want him to. This article has encouraged me to try and wean off it. I know it will be hard but I really want to try.
Thank you SOOOO much for this encouraging post!!!!! I read it a couple months ago and felt so much peace and also empowered.
We started the shield when my Rocky was 5 days old… Because every time I tried to feed him he would scream and get so stressed trying to latch that he would just pass out and sleep. He was tiny and I was big… I thought maybe the shield would help us for a few weeks while he grew and adjusted to things. (I used it with my daughter 8 years ago, for a week only, while healing up, and weaned her in a day)
We tried many times to do the sneak attack approach, taking the shield away after he latched on. It worked for a minute sometimes but then he would get so stressed out and scream. I kept trying for a few weeks occasionally, let him get familiar with me.
So fast forward, now Rocky is 11 weeks old. A few days ago I was sick And lounging around in bed and the couch with him. We took our time and I kept offering myself. I brought the shield back each time he got stressed..but as the day wore on it was less and less. The next two days we went completely without the shield. He seemed very agitated while nursing but I figured he just needed time to get comfortable with the new system. He seemed to not remember the shield though, as there was no screaming. Now we’re eating and latching peacefully each time.
I honestly think the shield was a huge hindrance to him because now he eats for shorter amounts of time and gulps more frequently. And it’s so much easier to nurse in public without having to constantly sneak the shield in and adjust it every time he unlatched. And milky spillage!!! Yuck!!!
I’m so proud of my boy, and myself. I have so much peace right now…I had anxiety before but just dealt with it.
There’s hope for us all, and this post was amazingly helpful!! Thank you!!
Renae and Rocky (Rockford)
Hi Renae. Thank you for this encouraging post. my daughter is 5 weeks old and I’m struggling to wean her from the shield. I’ll hope things also go well around 11 weeks!! congrats on your work.
I actually had to supplement with a SNS due to lack of weight gain and that’s what ended up helping me wean baby off the shield. I wonder if it would be a helpful tool for others too. It worked so well and we were off the shield in days.
How were you able to do that? I’m currently having to use the SNS to supplement feed but my baby won’t latch without a shield:(
Hi there! My baby is 3.5 months old and we’ve been using a nipple shield from the beginning due to flat nipples. I am exclusively breast feeding, and while the shield doesn’t bother me a ton, I would really like to get off it. But I’m worried—have I waited too long? Would things like skin to skin still help? Or is this plan more suited to newer babies? Also, is it possible for nipples to simply be TOO flat to be successful nursing without a shield or can anyone feasibly nurse?
This is a great question, I’m in the same boat. My baby is two months old and I have flat nipples. I’ve been using the shields as it seems to be the only way she’ll nurse. I’ve tried numerous times without the shield but she seems to just get frustrated and scream so I then put the shield back on and that’s when she seems to nurse really well and put on weight etc.
I’m trying to drop the nipple shield. My breasts feel empty and now baby is fussing with both bare nipple and shield, I don’t know what to do. Is it possible my supply has dropped because I’ve stopped using the shield? Her wet diaper count is the same, a little higher but it’s stressing me out that my supply is dwindling because i’m not nursing as long as I was with the shield/using the shield anymore.
Hi Madeleine, your comment got stuck in my spam queue and I just saw it so I’m sorry but I hope you connected with a knowledgeable IBCLC for support with your problems!
Great article, Rachel. I know many moms that will benefit from these tips.
We were never able to wean from a nipple shield with my first. I know in hindsight he had some unresolved issues and perhaps his tongue tie reattached and that could have been why. I could never get him to latch though without it. He still went on to nurse for 14.5 months before he finished. I have worked with several other mothers with similar situations. I always like to remind my moms that I work with that (like you said) don’t stress! Sometimes you can’t wean from it and you may not ever figure out why. This was an excellent post!
This list is great, validates the strategies we’re using with my little guy – of course I wish there was a silver bullet but this is encouraging.
And WOW to the poster who never weaned but nursed 14 months! Rock star. I’m committed to breast feeding but the shield drives me nuts at 5 weeks so can’t imagine!