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The Nipple Shield

Updated: Jun 1

Baby nursing at the breast with clear nipple shield

The nipple shield – what a polarizing little piece of plastic! Some of you have clicked on this article because you genuinely have no idea what a nipple shield is and are curious. Some of you have clicked because you are in the throes of nipple shield use and looking for some evidence-based information about use, duration of use, or how to quit using it. Finally, some of you have clicked because you might be anti-nipple shield or have worked with a lactation helper that was anti and are wondering what good could be said about the shield. No matter the reason, I am here to educate you, answer questions, and provide some guidance about the use of the…drum roll, please…nipple shield. 

Here is an example of a basic nipple shield. They are typically made of clear, lightweight, silicone plastic, mimicking the shape of an erect or evert nipple. They have a variety of uses in a breastfeeding journey, though in the lactation community people have mixed opinions about the use. Some feel very open to recommending or using the nipple shield while others will only recommend it in the most dire of situations. Some lactation professionals have strict rules or guidance about the length of use while others have a more laissez-faire approach. Either way, I hope this will help to educate you about the nipple shield so that if you find yourself contemplating use you can be an informed part of the decision-making team.

Common Reasons for Using a Nipple Shield:

  • Flat or inverted nipples

  • Nipple damage protection or nipple healing

  • Shallow latch, with or without the presence of tongue tie

  • Small or premature babies

  • Babies transitioning from bottle feeding to feeding at the breast

If you plan to use a nipple shield, make sure to sterilize it in boiling water before use. Then it should be washed with soap and hot water after every use. It can also be placed on the top rack of the dishwasher. It should be completely dry before use. With any evidence of damage or cracked plastic, it should be replaced. 

How to Use a Nipple Shield: 

STEP 1: Wash your hands. This should be commonplace when preparing to latch a baby to the breast

STEP 2: Place the dimpled center (think nipple cover portion) over your nipple. If your nipple is flat or inverted, try to center it as if covering an evert nipple.

STEP 3: Flip the plastic edge down onto your skin, so that it holds in place. It is intended to stay in place via body warmth, but using a little nipple balm or Aquaphor to get it to hold in place better is fine. 

STEP 4: Latch the baby. They should be tucked in close with their nose and chin resting on the breast. 

STEP 5: Feed. You should be able to see some milk in the shield, notice the baby’s suck and swallow pattern, and hopefully note that your breast feels less full. 

STEP 6: Remove the shield and switch sides, or if done, wash with warm water and soap. 

The nipple shield is intended to help solve a problem occurring with the baby latching to the nipple or assist in feeding at the breast. It is meant to be a temporary fix and is not intended to be a part of breastfeeding for the entire journey. Transitioning off the nipple shield can sometimes present a challenge. The nipple shield makes latching a little easier for some babies, so transitioning to latching at the nipple can be frustrating for them. It is not that they cannot breastfeed without it. Discontinuing a nipple shield is like learning any new skill; it takes time, practice, and plenty of patience. 

Tips for Stopping Nipple Shield Use:

  • Take a deep breath and summon your patience. Discontinuing the nipple shield can take time and effort. It is often not a linear journey and some regressions can be normal as the baby grows and changes. Be patient and continue to try. 

  • Try skin-to-skin. Having lots of skin contact with the baby prior to the feed can make latching without the shield feel more normal or natural to them. Skin-to-skin helps to regulate babies and is comforting to them.

  • Slow and steady wins the race. It will take time. Try latching to the nipple without the shield for certain feeds every day or just at the beginning of each feed. Eventually, you will get to the point of not needing the shield for a whole feed. 

  • Bait and switch. Begin the feed with the shield, and then part way in, pop it off, and latch to the nipple. The nipple should be more evert and the milk should be flowing at this point, so hopefully the baby will not object to no shield. 

  • Watch for early feeding cues! If a baby is actively crying and very hungry it can be harder to encourage a new skill. Try latching the baby early, when they are starting to stir or show early signs of hunger. That way, they will be calm and more willing to try to latch to the breast. 

  • Feed the baby! If the baby shows signs of hunger, always provide sustenance. While it is fine to try latching a few times prior to reverting to the nipple shield, it should never be a nipple shield or bust. 

  • Be prepared for potholes. There may be some bumps along the road to nipple shield discontinuation. Sometimes milestones, like the first round of vaccines or sleeping through the night, can throw off their normal rhythms. They may need the shield more for feeds. Using it more may feel like a regression, but it is not a linear journey, so do not worry. Just continue to work towards your goal.   

Why doesn’t everyone always use a nipple shield?

Transfer: Typically, a baby will be able to draw the milk out of the breast better or more efficiently if there is not a little piece of plastic covering the nipple. 

Convenience: It is much easier to latch a baby directly to the nipple without needing to have a shield on hand. It is one more step to add to the process and additional gear that is not always necessary. 

Deep latch: The hope is that barring complications, you will be able to achieve a deep latch from the beginning of your nursing journey. If there is any nipple damage, it will hopefully be transient, and latch will be easily fixed with a little assistance.

Term Delivery: The vast majority of babies are born full-term and will transition to extrauterine life without issue. They will not need extra support, specialized care, or end up in the NICU. These babies' oral development provide for a routine start to latching at the breast. It’s not always easy or perfect – everyone needs help, of course – but they will not automatically need a nipple shield. 

As an IBCLC, I find the nipple shield to be an awesome tool! It can be helpful in many breastfeeding situations but should be used with the intention of discontinuation at some point. I do not like to recommend strict or ultimatum-type timelines but do encourage the shortest necessary course. If you find that you struggle to latch without it and have tried all suggestions, reach out for help. Use the nipple shield as a tool with the ability to save a breastfeeding journey, but once you are thriving, fly without it. You have got this, Modern Mama!

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