Nipple shields are thin, flexible silicone devices designed to assist with breastfeeding when challenges make direct nursing difficult. These shields are placed over the nipple and areola, acting as a temporary interface between the mother and the infant. The design addresses mechanical and anatomical obstacles that can disrupt effective feeding. While they are a valuable tool, they are generally intended for short-term use under the guidance of a healthcare professional.
What Nipple Shields Are and When They Are Necessary
A nipple shield is typically made of soft, transparent silicone, featuring a cone-shaped teat section with small holes at the tip to allow for milk flow. The base rests against the breast and usually has a cut-out area to maximize skin-to-skin contact between the infant’s nose and the mother’s skin. The device works by providing a firmer, more extended shape than the natural nipple, which helps stimulate the baby’s sucking reflex.
These shields are most commonly recommended when an infant is struggling with latching onto the breast. This difficulty often occurs with preterm infants, who may have a disorganized suck or lack the oral strength for a full latch. Nipple shields can also be a solution for anatomical variations, such as flat or inverted nipples, by creating a stable target for the baby to draw into their mouth.
For mothers experiencing significant nipple pain or skin damage, such as cracking or severe soreness, the shield provides a protective barrier. By covering the injured tissue, it allows the mother to continue nursing while the nipples heal, preventing further friction or trauma. The shield facilitates feeding and should be used as part of a strategy to resolve the underlying latch issue. Lactation support is usually sought to ensure the shield is not masking an issue that needs correction.
Selecting the Right Size and Application Technique
Proper sizing of the nipple shield is paramount, as an ill-fitting shield can reduce milk transfer and cause discomfort. The correct size is determined by the diameter of the mother’s nipple, not the areola. The goal is to allow the nipple to move freely within the shield’s tunnel without rubbing against the sides. Generally, the shield’s tunnel should be approximately 2 to 4 millimeters larger than the diameter of the nipple at its base.
If the shield is too small, the nipple can be painfully compressed, leading to friction and potential injury during feeding. Conversely, if the shield is too large, it may not be stimulated effectively by the infant’s mouth, potentially hindering the milk ejection reflex. A lactation professional can measure the nipple accurately and observe a feeding to confirm the best fit for both comfort and milk transfer efficiency.
To apply the shield, moisten the rim with a few drops of water or breast milk to help it adhere securely to the skin. The shield should then be partially inverted, similar to rolling a sock, centered directly over the nipple, and the edges smoothed down over the areola. Positioning the shield with the cut-out section opposite the baby’s nose allows for a greater sensory connection during the latch. After each use, the shield must be washed in hot, soapy water and rinsed thoroughly.
Addressing Supply and Dependency Concerns
A primary concern associated with nipple shield use is its potential impact on the mother’s milk supply. The silicone barrier can sometimes lessen the tactile stimulation of the nipple, which is needed to signal the body to produce and release milk. This reduced stimulation, coupled with potentially less effective milk removal by the baby, may lead to a decrease in production over time if not monitored closely.
Another common issue is the risk of infant dependency, where the baby becomes accustomed to the specific shape and feel of the shield’s teat. This preference can make the transition back to the bare breast challenging, as the baby may resist latching without the familiar device. Because of these risks, monitoring the baby’s weight gain and wet/dirty diaper count is recommended to confirm they are receiving adequate nutrition.
If a potential supply risk is identified, a lactation consultant may suggest supplementing nursing sessions with pumping to ensure complete breast drainage and maintain milk production. They can also develop a structured plan to gradually wean the baby off the shield, often by removing it mid-feed once milk flow has initiated. Working closely with an International Board Certified Lactation Consultant (IBCLC) is the most effective way to manage shield use and establish a plan for its eventual discontinuation.