Nipple Shield – Uses, Benefits, and Tips

What Is a Nipple Shield?

A nipple shield is a thin, flexible silicone device that is placed over the nipple and areola during breastfeeding. It is designed to assist with various nursing challenges by providing a firmer surface for the baby to latch onto. Nipple shields typically feature a butterfly-shaped or round base and a protruding tip with small holes that allow breast milk to flow through to the baby.

Indications and Uses

Nipple shields are recommended in a number of situations:

• Flat or inverted nipples: When the nipple does not protrude sufficiently, a shield can provide a better surface for the baby to grasp.
• Sore or cracked nipples: The shield acts as a protective barrier, reducing direct friction and supporting healing of damaged nipple tissue.
• Latch difficulties in newborns: Premature infants or babies with a weak sucking reflex may find it easier to feed with the help of a nipple shield.
• Transitioning from bottle to breast: Babies who have been bottle-fed initially may accept the breast more readily when a nipple shield is used.
• Overactive letdown reflex: The shield can slow the milk flow slightly, reducing choking or gagging in the baby.

Proper Application

Correct usage is essential for effective breastfeeding with a nipple shield:

• The shield should be selected in the correct size. The nipple must fit comfortably inside the tip without being compressed.
• Before application, the shield can be slightly moistened or turned partially inside out and then placed over the nipple to improve adhesion.
• The baby should be latched as in normal breastfeeding – with a wide-open mouth and as much of the areola as possible taken in.
• During feeding, it is important to ensure the baby is swallowing effectively and receiving adequate milk.

Advantages and Potential Disadvantages

Advantages

• Enables breastfeeding despite anatomical challenges or nipple pain
• Can maintain the breastfeeding relationship during difficult phases
• Easy to use and widely available at pharmacies and baby supply stores

Potential Disadvantages

• Incorrect use may reduce milk supply due to decreased breast stimulation
• The baby may become dependent on the shield, making weaning from it more difficult
• There is a slightly increased risk of blocked milk ducts if the breast is not fully drained
• Strict hygiene is essential – the shield must be thoroughly cleaned after each use

Weaning Off and Alternatives

A nipple shield is generally intended as a temporary aid. Once the underlying breastfeeding issues have resolved, a gradual transition to direct breastfeeding should be attempted. This can often be achieved by removing the shield midway through a feeding session when the baby is already relaxed. A lactation consultant or midwife can provide valuable guidance during this process.

Alternatives to nipple shields include experimenting with different breastfeeding positions, applying lanolin cream for nipple care, and seeking professional lactation support.

When to Seek Professional Help

If pain persists despite using a nipple shield, the baby is not gaining adequate weight, or milk supply appears to be decreasing, it is important to consult a lactation consultant, midwife, or pediatrician promptly. Professional guidance is also recommended before using a nipple shield for the first time to ensure proper sizing and application.

References

1. World Health Organization (WHO) – Breastfeeding and the Use of Human Milk, Policy Statement (2023)
2. Chow, S. et al. – The Use of Nipple Shields: A Review. Frontiers in Public Health, 3:236 (2015)
3. Lawrence, R.A. and Lawrence, R.M. – Breastfeeding: A Guide for the Medical Profession, 9th Edition, Elsevier (2022)