Why I don’t like nipple shields

When I first started working as a lactation consultant (LC) almost 20 years ago, I must admit, I used nipple shields. I used them for some of the reasons people use them now, but not nearly as often as I’m currently seeing. They seem to be given out like candy before a mom leaves the hospital.

With experience, I’ve come to realize it’s much better to fix the latch rather than put on a barrier between you and your baby. I don’t think I’ve used one in over 10 years. I’m amazed how many times I visit a mom and she’s already using one, given to her by the hospital or another LC. Here are the reasons why people give them out, followed by what I believe should be done instead:

  • Sore nipples: Definitely don’t use a nipple shield for sore nipples! If your nipples are sore, it means you need to have a lactation consultant help you fix the latch. Furthermore, the shield will only rub on your sore nipples. I’ve even seen very abraded nipples as a result of using a nipple shield because it allows a mom to latch baby on nipple only and not really take in the areola.
  • Flat nipples: A good lactation consultant should be successful at teaching moms how to latch their baby on to their flat nipples. Nipples shields aren’t needed for this. In addition, many times I have gone to someone’s house and they’re using a shield given by hospital staff because they have “flat nipples,” yet the nipples are perfectly everted. When given a nipple shield, this mom received the message that her nipples aren’t good enough to nurse her baby.
  • Because their friend uses one: I’ve gotten phone calls from new moms who are desperately trying to breastfeed, and I’m simply asked if I sell nipple shields. They are sold at drug stores and moms buy them without any guidance.

If a mom truly has very inverted nipples, it will give the baby something to grab onto, but truly inverted nipples are just not that common. This is, however, a good use of a nipple shield. If a baby has been drinking from a bottle and then tries to get onto the breast, it may be useful to use the shield, but only for a few seconds. There are other, better ways to latch a baby onto the breast after using a bottle.

The really scary thing I’ve seen is poor milk transfer when moms use a nipple shield. This happens because no one has actually helped the mom latch the baby on with the shield and the baby is latched too close to the nipple, thus not really nursing and not stimulating the milk supply. If a baby isn’t transferring milk well, then the weight gain won’t be sufficient and the milk supply will decrease.

Nipple shields aren’t the great panacea. It’s much better to find an experienced lactation consultant.

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