Breastfeeding is an incredible journey, but as we all know, it comes with its challenges and doesn’t always go smoothly. There’s still a lot of controversy surrounding the use of nipple shields, and the most important thing to remember is that, like everything in life, there’s no one-size-fits-all solution.
What prompted me to write this post was a visit I had with a mother last week. She was in absolutely agony while feeding, with deep cracked nipples. The professionals at the hospital had checked the latch and told her it was fine, and that she should “just get used to it”. I was appalled when I heard this. For anyone reading this blog, you should know that you do not need to get used to pain. Listen to your body. How can anyone say that to a mother in tears while trying to breastfeed? I’ll save the full story for another blog post, but needless to say, the situation left me feeling sad, frustrated, and disappointed.
The point is that nipple shields can literally be a lifesaver on the breastfeeding journey. This mother was able to continue breastfeeding her baby directly from the breast using the shields. But of course, nipple shields can also cause issues and completely ruin the experience if they’re not used properly. That’s why it’s so important to use them with the guidance of an IBCLC lactation consultant to avoid any further problems like nipple pain or a drop in milk supply.
In this blog, I’ll answer the five WH-questions about nipple shields: What is a nipple shield, when it should be used, who can benefit from it, how to place one, and which size should I choose. And as usual, I will share my top 5 tips for weaning off nipple shields.
What is a Nipple Shield?
A nipple shield is a small, flexible, thin, and soft piece of silicone placed over the nipple during breastfeeding. They come in different sizes and shapes depending on the brand.
Before using a nipple shield, it’s essential to get the right size to prevent further nipple damage. If the shield is too small, the nipple will be compressed and rub against the sides, leading to pain and discomfort. If it’s too big, too much of the areola may be drawn in, which can also cause pain and possible damage.
When to Use a Nipple Shield?
While nipple shields aren’t always necessary, they can be incredibly helpful in overcoming certain breastfeeding challenges, especially as a temporary measure. They are not a long-term fix, so it’s crucial to understand the root of the problem and work toward a sustainable solution.
Ideally, nipple shields should be used alongside professional breastfeeding support from an IBCLC lactation consultant. I’ve had patients who were initially told to use shields because their baby couldn’t latch, or because the latch was shallow and painful. After making just a few positioning tweaks, those same mothers were confidently feeding without shields.
Who Can Benefit from Using a Nipple Shield?
Nipple shields act as a protective layer between the nipple and the baby’s mouth. Here’s who may benefit:
- Premature babies: They often have weaker sucking reflexes, and they get tired quickly when sucking. A nipple shield can help them latch longer and transfer milk more effectively.
- Mothers with very flat or inverted nipples: Flat or inverted nipples shouldn’t automatically mean using a shield. Babies should always be given the chance to latch naturally, especially in the first hours.
- Babies with tongue-tie or oral difficulties: If a baby has restricted tongue movement or weak suction, a nipple shield may help them grip and suck more efficiently.
- Babies with latch difficulties: If you’ve worked with an IBCLC and your baby still can’t latch properly, a nipple shield might offer temporary support until underlying oral issues are resolved.
- Mothers with sore or cracked nipples: Shields can reduce friction during feeds, giving nipples enough time to heal.
- Babies experiencing breast refusal: Some babies who are used to bottles may refuse the breast. Shields can mimic the feel of a bottle teat and ease them back to breastfeeding. It will always be better breastfeeding with nipple shields, over expressing milk and give it with a bottle.
- Mothers with overactive letdown: A fast milk flow can overwhelm some babies. Tricks like using a Haakaa to catch the initial letdown may help, but if that’s not enough, nipple shields can moderate the milk flow.
How to Place a Nipple Shield?
One common issue I see in consultations is mothers being told to use nipple shields without any support from the professionals attending them or being shown the wrong way to place them.
Correct placement is key to ensuring effective milk transfer and maintaining your milk supply. It also helps the shields stay in place throughout the feed, even if the baby moves.
Here’s how to use a nipple shield properly:
1. Wash your hands.
2. Clean the nipple shield: Sterilise the shields before the first use, and then wash with hot soapy water after each feed.
3. Partially invert the wings and flip the tip of the cone outward.
4. Place the central part of the cone over your nipple, let go of the wings, and press until it suctions on, drawing the nipple gently into the tip.
5. Check for a secure fit: You will know if the nipple shields are well placed, because they should stay in place during the entire feed without you needing to hold them.
6. Encourage a deep latch: Baby’s mouth should cover both the tip of the nipple shield and part of the areola, and you should hear the baby swallowing.
7. Check for milk transfer: After the feed, you should see milk pooled in the shield.
If you’re still experiencing pain, discomfort, or a poor or shallow latch, it could be a sign the shield isn’t fitted correctly. Reach out to an IBCLC for help.
Which Size Should I Choose?
Nipple shields are widely available in pharmacies, baby supply stores, and online, but finding the right size is crucial for an optimal use. Different brands have different sizes, shapes, and materials, so it’s best to work with a lactation consultant who can measure your nipple and recommend the most suitable shield. The ideal size allows your nipple to move freely inside the funnel without rubbing or being compressed.
If you’re doing it on your own:
- Measure the base of your nipple (not the areola) using a ruler.
- If you’re measuring before a feed, add an extra 2mm.
- You can also gently finger stimulate your nipple to get it as erect as possible to make it easier to measure it and it’s also more accurate.
My Top 5 Tips for Weaning Off Nipple Shields
It’s important to respect your baby’s readiness when weaning off nipple shields. Whether you were using them to heal sore or cracked nipples, improve latch, or support a premature baby – timing matters. If your baby still struggles, it may not be the right time to stop. Weaning should be gentle, gradual, and baby-led.
Here are my top 5 tips:
1. Skin to skin contact and spontaneous latch: Increase skin to skin time. It promotes natural instincts and helps your baby find the breast on their own.
2. Offer the breast without the nipple shields: Try this during night feeds or calm moments. If your baby gets frustrated, put the shield immediately back and try again next time.
3. Remove the shield mid-feed: Once baby is sucking well, gently remove the shield and offer the breast. If they resist, no worries, pop the shield back on and try again on the next feed.
4. Shape your breast: Use your hand to shape your breast with a “C” shape and aim the nipple toward baby’s nose. Ensure the chin is touching your breast to get more breast tissue inside of the mouth, and a deeper latch.
5. Don’t give up at the first attempt: It’s normal for your baby to refuse your nipple without the shield. It may take a few attempts (or many), and that’s okay. Do not stress as things will be more complicated.
To conclude, nipple shields can offer amazing support in specific breastfeeding situations; however, they work best when used intentionally, with professional guidance, and as a temporary solution.
I hope this guide reassures you and gives you all the information you need to feel empowered and confident when using nipple shields.
And remember, every breastfeeding journey is unique, and what worked for your friend might not work for you, and that’s perfectly okay. Always reach out to an IBCLC if you’re unsure or need personalised support.
