The Nipple Shield Guide: All Your Questions About This Handy Breastfeeding Tool Answered

Read on to find out if using a nipple shield might be the solution to your breastfeeding problems.

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Breastfeeding comes naturally and is a breeze for some. Unfortunately, this isn't the case for everyone and often, mums struggle to breastfeed for many different reasons. The good news is that most of these problems have solutions. Using a nipple shield is one of the solutions that has helped many struggling mums overcome their breastfeeding obstacles. 

However, some mums have heard of a nipple shield but aren't too familiar with it. Here's a list of common questions that mums have about nipple shields. 

What is a nipple shield and how does it work? 

To get things started, let's have a clear understanding of what a nipple shield is. A nipple shield is a flexible silicone nipple that is worn over the breastfeeding mother's nipple. Simply put, it is an artificial nipple sheath. 

While nipple shields are mostly made of silicone, they do also come in rubber and latex materials. In some parts of the world, you can even find glass or wax nipple shields! 

The nipple shield mainly covers your areola (the dark area around the nipple) and it has holes close towards the nipples. The holes help to regulate the milk flow and in turn, make feeding easier for your baby. 

If you are worried that using a nipple shield restricts skin-to-skin contact, don't worry. Some nipple shields come with an area around the brim that allows the baby's chin or nose to come directly in contact with the mother's skin.

Image Source: iStock

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Why would I need a nipple shield?

1. If you have a small or premature baby 

Babies who are very small face difficulties when trying to suck milk. It might take a few weeks for them to stabilise and get better at sucking. Babies who are ill may also have problems sucking.

A nipple shield makes it easier for a small or weak baby to feed as the suction inside the nipple shield keeps the nipple in an everted position. Milk collects in the tip of the shield and this gives the baby instant gratification! This will also help the baby's growth. 

2. If you have flat or inverted nipples 

If you ever heard that you can't breastfeed if you have flat or inverted nipples, that's not true at all! Sometimes, new mums have nipple tissue that doesn't have much elasticity. This makes it difficult for babies to draw out the nipple and they may end up crying or falling asleep.

Using a nipple shield helps to solve this problem by providing babies with a sensation similar to when the nipple touches the roof of their mouth. In this manner, the baby feels encouraged to continue sucking. If the baby continues to suck, the nipple will eventually elongate and you won't need the nipple shield anymore. 

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3. If your baby has tongue or lip tie 

A small number of babies are born with a tongue and/or lip tie. In such cases, the connective tissue prevents the baby from fully extending his tongue or flanging his lip which in turn causes problems in latching. Using a nipple shield allows a baby to breastfeed in spite of a shallow latch. Once the lip or tongue tie is resolved, there will no longer be a need for a nipple shield.

4. If you have sore breasts or cracked nipples 

We all know how excruciating it is to breastfeed when our nipples are cracked. Some mums have completely given up breastfeeding because of the unbearable pain. Using a nipple shield enables the baby to suck milk while protecting your nipples and areola. 

5. If you have an overactive let-down 

Overactive letdown causes some babies to choke and splutter while breastfeeding.

Some mums experience their milk coming in with a force that causes their baby to choke or pull off the breast. Using a nipple shield greatly helps in regulating the milk flow. When the baby is more used to feeding, he will be able to regulate the milk flow and you will no longer need the nipple shield. 

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How long will I have to use a nipple shield?

Mums, don't be under the false impression that using a nipple shield means that you will never be able to naturally breastfeed your child again. Remember that nipple shields are after all a solution to a particular breastfeeding problem that you might be facing.

As such, nipple shields are a short-term solution to tide you through until you sort out the problem, or your baby gets more stable. It's always best to use a nipple shield under the guidance of a lactation consultant.

If someone recommends that you use a nipple shield within a few days of delivering your baby, don't be too quick to use them unless you have an actual need to. It's best not to use a nipple shield in the first week of birth unless the baby is premature or has a problem latching

Having said that, don't delay using a nipple shield if you need to. If you wait for more than 6 days past your baby's birth, you might end up with engorgement

How do I use a nipple shield? 

Especially if you are using a nipple shield for the first time, it's best that you get a breastfeeding counsellor or a lactation specialist to take you through the process. 

This is what you need to do before using a nipple shield:

  • Sterilise the nipple shield
  • Rinse and wash the nipple shield gently with warm, soapy water (this helps to soften the nipple shield and makes it easier to put on)
  • Wash the nipple shield after every use
  • Ensure that the nipple shield is dry when you use it 

How to put on a nipple shield 

Here is a simple pictorial guide to using a nipple shield:

It might take a little getting used to

What do I need to look out for when using a nipple shield?

Using a nipple shield isn't only about providing relief and comfort. Ultimately you need to ensure that your baby is getting enough milk. Again, it's best to check with a lactation consultant, but here are some basic things to look out for:

  • Ensure that your baby is latching on properly. Your baby's jaw should be close to your breast but not on the shaft of the nipple shield.
  • Ensure that your baby is producing five to six wet diapers a day.
  • Ensure that your baby has regular stools (at least 3 times a day for babies between 4 to 6 weeks old)
  • Ensure that your baby is gaining sufficient weight

It's also important that you check that your baby is not taking in air. Doing so might cause colic and you do not want that.

Check that your baby is trying to suckle with his tongue touching the roof of his mouth. This makes it possible for your baby to stop the milk flow when he is full. Listen out for soft gulping sounds and watch his lower jaw moves. This is a sign that he's not taking in air. 

Apart from this, you must ensure that your breasts are emptied properly. It's best that you pump out the excess milk after you finish breastfeeding using a nipple shield.

You must also ensure that you are using a nipple shield of the right size. Here's a visual guide to help you out:

Image Credit: Medela.com

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The best nipple shield to use is the thin, clear silicon type. These are easy to clean and last longer. They are better than the rubber ones. 

The pros and cons of using a nipple shield

What are the advantages of using a nipple shield?

Of course, it's ideal not to use one, as natural is best but the main advantages are the relief from painful nipples and enabling your baby to feed well in spite of the challenges.

What are the disadvantages of using a nipple shield?

Although nipple shields are a great solution to breastfeeding problems, they can cause some problems. 

  • You may end up with plugged ducts if your milk doesn't flow as it should
  • Using a nipple shield of the wrong size can cause pain
  • You may end up with mastitis 
  • Your baby may have trouble weaning from a nipple shield

How do I wash my nipple shield?

To clean your nipple shield properly, it's essential to follow some simple steps to maintain hygiene and ensure your baby's safety during breastfeeding.

Before using the nipple shield for the first time, sterilise it to remove any potential bacteria. After each use, rinse and wash the nipple shield gently with warm, soapy water to keep it clean and soft. Always ensure that the nipple shield is completely dry before using it again. Regularly washing the nipple shield after every use is essential to prevent any milk residue buildup.

When it comes to the material, thin, clear silicone nipple shields are recommended as they are easy to clean and tend to last longer

Is it okay to use a nipple shield permanently?

Using a nipple shield permanently is not generally recommended as it may have both advantages and disadvantages. A nipple shield can be beneficial in certain situations, such as when a baby is having difficulty with latch-on or if the mother experiences nipple trauma, as it can help prevent nipple pain and promote a deep latch on the breast, leading to more comfortable breastfeeding.

However, using a nipple shield for an extended period may reduce the stimulation the mother's body receives during breastfeeding, potentially leading to lower milk production.

A lactation consultant can assess the baby's latch and positioning and provide personalised advice based on your needs. While a nipple shield can be a helpful tool in certain cases, it's essential to seek guidance from a healthcare professional to ensure successful and comfortable breastfeeding for both you and your baby.

How do I wean my baby from a nipple shield?

Image Source: iStock

1. Do it gradually. It cannot be a sudden change for your baby.

2. Wait until your baby is a bit full, then try to switch him back to the breast. Doing it when your baby is starving will make him upset and might lead to a milk strike altogether. 

3. A good time is when you are switching breasts. This helps to make sure that your baby continues suckling. 

4. When your baby is used to suckling from your nipple on one side and the shield on the other, try removing the nipple shield during a feed. But don't do it suddenly. Look out for queues like when your baby pauses to take a breath, and make use of the opportunity.

5. Make your baby comfortable and in a position that faces you so that he doesn't have to turn his head to suckle.

6. Pump some milk or press your breasts so that your baby doesn't need to suck hard or put in too much effort to get his milk. This also elongates your nipple and makes it easier for your baby to feed.

7. Help your baby to open his mouth. You can use your pinky finger to help. As your baby sucks on your finger, he will touch the roof of his mouth with his tongue. This is how he should be drinking from the breast.

We hope we have answered all your questions about using a nipple shield. It might be a bit tricky initially, but with practice, and the guidance of a lactation consultant, you're sure to get the hang of it!

ALSO READ:

Breastfeeding FAQs: Positions to Master at the Start of Your Breastfeeding Journey

How to Stop Breastfeeding: Let’s Talk About Weaning Your Baby Off The Breast

Hypogalactia: What To Do When Your Breasts Don’t Make Milk

Written by

Nasreen Majid