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Nipple Shields

Shields, yes or no?
Nipple shields are readily available in Australia for purchase by expecting parents to aid breastfeeding. But are they necessary? Who will they help, and is it possible they could hinder your breastfeeding success instead of support it?

Firstly, why use a nipple shield?
This thin, flexible silicone ‘crown’ or ‘hat’ is used to assist with attaching the baby to the breast. Particularly in circumstances where the nipple is short, flat or not easily pliable.
Nipple shields help to ‘lengthen’ the nipple therefore stimulating baby’s sucking reflex. This is found at the junction of the anterior and posterior palate.
This promotes a more effective and nutritive latch.
They are NOT for protecting a grazed or painful nipple from further damage.
When not used for the appropriate reasons or with the correct technique, nipple shields can actually cause further damage to the nipple and areola as well as inhibit effective milk transfer.

When? 
Nipple shields should not be used before the milk has begun to come in (2-6 days postpartum)
They are a temporary intervention, similar to using training wheels on a bike. Once your baby has learnt to attach well and often with a good milk supply in place, the shields can be weaned slowly away.
Commencement should be under the supervision and/or suggestion of a health professional apt in technique education and able to monitor your baby for signs of adequate intake.


References
Auerbach, K., 1990. The Effect of Nipple Shields on Maternal Milk Volume. Journal of Obstetric, Gynecologic & Neonatal Nursing, 19(5), pp.419-427.
Eglash, A., Ziemer, A. and McKechnie, A., 2010. Health Professionals' Attitudes and Use of Nipple Shields for Breastfeeding Women. Breastfeeding Medicine, 5(4), pp.147-151.
Kronborg, H., Foverskov, E., Nilsson, I. and Maastrup, R., 2016. Why do mothers use nipple shields and how does this influence duration of exclusive breastfeeding?. Maternal & Child Nutrition, 13(1).
McKechnie, A. and Eglash, A., 2010. Nipple Shields: A Review of the Literature. Breastfeeding Medicine, 5(6), pp.309-314.
Wilson-Clay, B., 1996. Clinical Use of Silicone Nipple Shields. Journal of Human Lactation, 12(4), pp.279-285.


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