Nipple Shields: Pros and Cons of Nursing Aids

What Size Should the Nipple Shield Be?

Nipple shields come in various shapes and sizes. The right size depends entirely on your breast. Here are a few guidelines to help you choose the right size:

• The nipple shield should be as large as necessary but as small as possible.
• The thinner the material, the better, as it feels more natural for both mother and child.
• The shield should be large enough that the nipple is completely within the raised part of the nipple shield, allowing it to fully expand while nursing.

It's best to try out different sizes and shapes if needed. Your midwife or gynecologist will surely assist you with this.

What Are the Benefits of Nipple Shields?

Especially at the beginning, when both mom and baby are facing breastfeeding challenges, nipple shields can be temporarily useful. They are recommended in the following situations:

• For newborns—especially preemies—it can be very exhausting to suck at the breast initially. Nipple shields can make sucking easier for the baby.
• A mother's breast may not yet be accustomed to regular breastfeeding and can easily become sore and painful. Nipple shields can alleviate or even eliminate this pain.
• Mothers with inverted, flat, or sore nipples may initially struggle with latching. Nipple shields provide the right shape and can facilitate breastfeeding.
• Sometimes, newborns may not yet know how to suck properly. Nipple shields can trigger a stronger sucking reflex in infants due to their exaggerated shape.
• The cavity between the shield and the skin retains some milk, and the smell of the milk encourages the baby to continue sucking.
• If the baby has a shortened frenulum and thus has trouble sucking, the nipple shield can help.

In all these cases, it's important not to reach for nipple shields immediately but to seek professional advice first. Your midwife, doctor, or a lactation consultant can help you find the right latching technique or a better breastfeeding position, often making nipple shields unnecessary.

How Do You Use the Nipple Shield Correctly?

First, you should wash your hands. Then, moisten the inside of the nipple shield so it doesn't slip. When latching, ensure that the raised part of the shield is directly over the nipple. This creates a vacuum, allowing your nipple to expand optimally. Important: Even when breastfeeding with a nipple shield, try to maintain as much skin-to-skin contact with your baby as possible. Ideally, your baby should be positioned so that their chin touches your breast. Some nipple shields have special cutouts at the edge for this purpose.

Clean your nipple shields after each feeding with warm water and a gentle detergent, and boil them for at least five minutes every 24 hours to kill any germs.

What Are the Disadvantages of Nipple Shields?

Despite their many benefits, many mothers, doctors, and midwives believe that the disadvantages of nipple shields outweigh the advantages:

• Since sucking on nipple shields is much easier for newborns, they quickly become accustomed to them. Weaning can then be more challenging, as infants may find it harder to drink directly from the breast.
• Due to the lack of skin contact, the breast is not stimulated as strongly, which can lead to decreased milk production or prevent it from starting properly.
• As a result of low milk production, it may happen that the baby does not gain enough weight.
• While nipple shields can protect sore nipples when used correctly, improper use can worsen the pain. Additionally, sore nipples are often a result of incorrect breastfeeding positions, which nipple shields do not address.
• If nipple shields are applied incorrectly, or if they are too small or too large, they can even cause sore nipples and pain.
• After latching, hardening may occur at the nipple because the baby may not fully empty the breast. This can lead to a milk blockage.
• Babies cannot be breastfed spontaneously. Whether on the go or at night, properly positioning a nipple shield requires attention and time. Discreet breastfeeding in public becomes more difficult, and sleep and rest are lacking at night.
• Mother and child become dependent on a piece of plastic. Additionally, nipple shields need to be regularly cleaned and boiled.

Finally, in hospitals or during the postpartum period, nipple shields are often recommended because they provide a straightforward and quicker solution at the beginning. However, a nipple shield is often not necessary at all. Proper and thorough advice could resolve potential breastfeeding issues much better and more permanently. In contrast, nipple shields merely shift the breastfeeding difficulties to the time after leaving the hospital or after the postpartum period.

How Do I Wean My Child from the Nipple Shield?

Nipple shields are never recommended as a long-term solution. Ideally, you use nipple shields for as long as necessary but as briefly as possible. However, even with short-term use of nipple shields, there may be a refusal of the breast afterward because sucking on the plastic shields is so easy. This refusal is also known as nipple confusion.

To counteract nipple confusion or prevent it from arising, here are a few tricks to help your baby (re)learn to breastfeed:

• As soon as your baby's initial hunger is satisfied, gently remove the nipple shield but allow the baby to continue drinking immediately.
• Start breastfeeding without the nipple shield, but pump a little milk beforehand. This relieves the pressure, allowing the milk to flow better and making it easier for your little one to latch onto the nipple.
• Another effective method: Gradually guide your baby from the breast with the nipple shield to the breast without the nipple shield while nursing. This tactic works particularly well with the football hold.
• If it doesn’t work right away despite these tips: Don’t put yourself under time pressure when weaning, and avoid trying it when you or your baby are not feeling well or have had poor sleep. Just try again on a more relaxed day.

Learn how nipple cream can help with sore nipples and find more tips and answers to common breastfeeding problems here at ELTERN.