How Do I Know If I Need A Nipple Shield? Experts Explain How They Work & Who Needs Them Most

I used to think breastfeeding was a straightforward, easy peasy process. Hold baby up to your breast, and voila – they'll drink until they're full. Then I got pregnant, and I started doing my due diligence. I read about supply issues and latching pain and clogged ducts and suddenly my naïveté vanished. One of my first questions was, what the heck are nipple shields, and how do I know if I need a nipple shield? I can't be the only one overwhelmed with the boundless information available online, so I went straight to the experts.

Irene Zoppi, R.N., M.S.N., IBCLC, is the Clinical Education Specialist for Medela in the Breastfeeding Division, focusing on Advocacy Outreach. If anyone can explain the ins and outs of nipple shields, it's her. "Many moms use nipple shields to help establish a latch when other approaches aren’t working," Zoppi explains to Romper. "Made of thin, soft, silicone that doesn’t interfere with nipple stimulation, the Medela nipple shield is worn during breastfeeding. Holes at the tip allow milk to flow to the baby."

For Megan Covert, certified lactation counselor and owner of Indiana-based Covert Lactation Counseling, nipple shields can be incredibly useful solution for mothers and babies struggling with various feeding issues, from inverted nipples to flat nipples to latching difficulties. "Typically, we don't offer nipple shields unless it is absolutely necessary," Covert explains to Romper. "We only recommend you resort to them if you and your certified lactation counselor come to that conclusion."

But how exactly do these nipple shields work? For babies with latching difficulties, particularly babies born prematurely who are unable to create a strong latch, shields can be a great temporary solution. "The nipple shield holds the nipple in an extended position. This makes it easier for the baby to pause and breathe without having to change positions," Zoppi tells Romper. "There is research that shows that preemies get more milk when a nipple shield is used." Another potential breastfeeding hurdle – having flat or inverted nipples – can be remedied with nipple shields. "The nipple shield, shaped like an extended nipple, gives baby a larger area for latching and through repeated suckling, the nipple can be drawn out," Zoppi explains to Romper.

If you and your lactation consultant have decided it's time to try a nipple shield, the first hurdle is finding one that is properly fitted for your nipples and your baby's mouth. "Mom should take care not to 'stuff' her nipple into a too small nipple shield. If a shield is too big, baby might gag or have trouble drawing out the nipple. We recommend starting with the smallest size shield that can accommodate your nipple," Zoppi says. "Medela makes several types of nipple shields; the Regular, and Contact Nipple Shields which are available in 16mm, 20mm and 24mm." A lactation consultant can confirm that you've selected the proper size.

While nipple shields can be hugely helpful for babies having latching difficulties, Covert urges moms to view them as a temporary solution rather than a long-term fix. "Certified lactation consultants can usually teach you techniques to fix your issue and try to refrain from resorting to one. Long-term shield use may result in negative ramifications on your precious milk supply, and can put the baby at increased risk of failure to thrive," Covert says. "Be sure to talk to your lactation consultant about a milk expression plan to help maintain your milk supply while using the shield."

While using a nipple shield, it's crucial to make sure your baby is getting enough milk. If they aren't taking in enough, you're at an increased risk of experiencing mastitis, clogged ducts, and a reduced milk supply — not to mention a hungry, upset baby. "Make sure your baby is still latching deeply to the breast—his mouth should be open wide and his lips and cheeks should be touching the breast, not sliding back and forth on the shield," instructs Today's Parent. Your baby should be producing six "really wet" diapers within every 24-hour period.

One problem some mamas experience after using a nipple shield is a baby who's become dependent on it. If this occurs, an experienced lactation consultant can help you "ween" baby from the shield and get them accustomed to the bare nipple. "Try pumping briefly before bringing baby to the breast. This can draw out the nipple and promote let down, so when baby latches, he or she will be rewarded quickly," Zoppi explains to Romper. "Another approach to try: begin breastfeeding with the shield. If/when baby breaks the latch, try resuming the session without the shield. The process might take more than one attempt, so if it doesn’t work the first time, try not to get too discouraged."

For many new mamas, breastfeeding is not easy or straightforward. Issues, problems, and struggles arise, but with an arsenal of helpful tools and supportive professional guidance, you can ensure baby is fed and mom is happy. "Babies don't come with manuals and neither do your breasts. So when using the two together properly, with advice from loving professionals, your breastfeeding journey can go as smooth as a well-oiled machine," Covert says.

After experiencing a traumatic c-section, this mother sought out a doula to support her through her second child’s delivery. Watch as that doula helps this mom reclaim the birth she felt robbed of with her first child, in Episode Three of Romper's Doula Diaries, Season Two, below. Visit Bustle Digital Group's YouTube page for more episodes, launching Mondays in December.

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