A nipple shield is a thin, flexible piece of molded silicone placed over the nipple and areola during breastfeeding. This tool is often recommended by lactation professionals to help overcome various challenges. Common reasons for using a shield include assisting a baby with latch difficulties, providing structure for premature infants, or helping a baby latch onto flat or inverted nipples. The shield adds length and texture, which can stimulate the baby’s suck reflex, but its effectiveness relies on selecting the correct size to ensure both effective milk transfer and maternal comfort.
Why Correct Nipple Shield Sizing is Essential
Choosing the right size shield directly impacts the mechanics of milk removal and breast health. An improperly sized shield compromises the vacuum seal necessary for the baby to effectively draw milk from the breast. This poor suction leads to decreased milk flow and can cause the baby to become frustrated.
If the shield is too small, the nipple is forced to rub against the sides of the tunnel, resulting in friction, pain, and tissue damage. This restricted movement also compresses the milk ducts, interfering with the natural flow and drainage of the breast. Conversely, a shield that is too large may cause the nipple to be drawn too far into the tunnel or result in milk pooling and leaking. Pain or discomfort resulting from poor fit can undermine the goal of successful, long-term breastfeeding.
Step-by-Step Guide to Nipple Measurement and Shield Selection
Selecting the right nipple shield size focuses solely on the nipple diameter, not the surrounding areola. You will need a standard ruler or a flexible measuring tape, preferably one with metric markings, as shield sizes are universally measured in millimeters (mm). Measure the nipple when it is relaxed or before a feeding, as the size may change slightly after stimulation.
To obtain the measurement, place the ruler across the base of the nipple, measuring the diameter where the nipple meets the areola. Record this measurement in millimeters (mm). This measurement represents the minimum space required for the nipple to pass through the shield’s tunnel without rubbing.
The correct shield size is not equal to the nipple diameter, as the nipple needs clearance to move freely during the baby’s suckling action. A widely accepted guideline is to add an allowance of approximately 4 mm to the measured nipple diameter to determine the appropriate shield size. For example, a 16 mm nipple diameter would typically require a 20 mm shield size (16 mm + 4 mm).
This allowance ensures that the nipple can elongate and move within the tunnel without friction or blanching. Shield sizes vary between manufacturers, so always check the manufacturer’s specific sizing chart and measurement recommendations before purchasing a shield.
Recognizing and Addressing Poor Fit During Use
The final confirmation of correct sizing occurs during use with the baby. A well-fitting shield allows the nipple to move freely inside the tunnel and elongate naturally without hitting the tip of the shield. The mother should feel no pain, pinching, or rubbing sensation while the baby is feeding.
Signs of a poor fit include:
- The nipple suctioning through the holes at the tip (too small).
- The nipple appearing blanched (white or purple discoloration) after feeding (too small).
- Significant milk leakage around the edges (too large).
- The shield not adhering well to the breast and slipping off easily (too large).
- The baby struggling to maintain a seal or showing ineffective swallowing, suggesting poor milk transfer.
If the initial size selection does not feel right, try one size up or one size down from the original selection. Because different brands have varying shapes and lengths, switching to a shield from a different manufacturer may also improve the fit. Consulting a board-certified lactation consultant is the recommended next step, as they can visually assess the fit and the baby’s latch to ensure the shield is being used correctly and effectively.