Breastfeeding with a nipple shield is common today, but it can lead to unforeseen problems.
Before you breastfeed with a nipple shield, gather all the information you need. You may not need to use a nipple shield! If you are one of the moms that would benefit from a shield though, make sure you have the information you need to do it right.
Breastfeeding is natural but it isn’t always easy!
We’ll go over all you need to know about nipple shields so you can make an informed decision.
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Should You Use A Nipple Shield?
First, determine if you should use a nipple shield.
Nipple shields should only be used temporarily in most circumstances.
Consider using a nipple shield if you have:
- Inverted or flat Nipples. Inverted or flat nipples can be difficult for a baby to latch on to. Sometimes using a nipple shield will help to draw out your nipples. Your baby also has a reflex to suck when they feel a nipple in their mouth- so flat or inverted nipples might reduce your baby’s suck reflex. A nipple shield can help. Try to use this only temporarily when learning how to latch and breastfeed- even with flat or inverted nipples as your baby grows, they may no longer need the shield.
- A Premature Baby. Some premature babies have difficulty latching on to the breast. Their mouths are very small and they lack muscle tone in their face and jaw. Breastfeeding with a nipple shield might be useful for a premature baby until they are developmentally ready to breastfeed and latch.
- A Baby With Nipple Confusion. Some babies start to prefer a bottle to breastfeeding. When this happens, sometimes a nipple shield helps wean the baby off the bottle and get them back to the breast.
- Damaged Nipples. If your nipples are severely damaged, a nipple shield can help protect them while they heal. It isn’t always useful for nipple pain but could be a temporary option. Ultimately, the cause of damage should be determined and resolved.
- Nipples Too Large For Baby To Latch On To. Some babies have small mouths that have difficulty latching on to large nipples. It’s okay! Your baby will grow and become a more efficient nurser. In the meantime, a nipple shield can help your baby latch on. Breastfeeding with a nipple shield should only last until your baby is able to latch without one.
When You Shouldn’t Use A Nipple Shield
You shouldn’t use a nipple shield if:
- Your Milk Hasn’t Come In Yet. Using a nipple shield before your milk comes in could create a problem where that isn’t one. Some babies have difficulty latching and breastfeeding before your milk comes in (colostrum in the first days is thicker and harder to get to). They will often latch and feed effectively after your milk comes in. In the meantime, express colostrum onto a spoon, cup or syringe to feed your baby.
- You Have Sore Nipples. If your nipples are sore in the first weeks breastfeeding, a nipple shield likely won’t help. Your nipples likely will still be sore and a nipple shield can cause your milk supply to decrease. It’s expected that your nipples will be sore when first starting to breastfeed (kind-of like breaking in a pair of shoes). If you have severe nipple pain, bleeding, or cracking, you need to try and determine the problem. Often a good breastfeeding latch will fix it.
Nipple Shield Pros And Cons
There are some good things associated with breastfeeding using a nipple shield, as well as some bad things. Let’s go over the pros and cons so you can determine if it’s a good option for you.
Most health care providers recommend avoiding nipple shields if you can help it but the benefits might outweigh the negatives for you.
Pros Of Using A Nipple Shield
- A nipple shield doesn’t move or recede when your baby latches on.
- Nipple shields can help babies get back to the breast when they’re used to the bottle.
- Inverted nipples can be drawn out by using a nipple shield while breastfeeding.
- A baby with low muscle tone or a small mouth may be able to latch better with a nipple shield.
- Nipple shields can offer a temporary solution for damaged nipples to heal.
Cons Of Using A Nipple Shield
- Often nipple shields don’t help with pain as expected.
- Breastfeeding with a nipple shield can cause milk supply to drop.
- Nipple shields can lead to poor milk transfer and result in baby losing weight.
- Using a nipple shield while breastfeeding can cause clogged ducts and mastitis.
- Babies can become dependent on using a nipple shield.
- Nipple shields are difficult to use in public.
Ultimately, the choice to use a nipple shield is yours! You might find it helps with the breastfeeding journey. In the long run, it’s probably better to only use it temporarily but each breastfeeding journey is different.
Weigh the pros and cons to determine if using a nipple shield is a good option for you.
How To Use A Nipple Shield
Here are the steps you need to take if you decide to use a nipple shield!
They are a lot easier to use when you know how to do it! (Trust me… the first time I used one I had no idea what I was doing).
When you use a nipple shield you need to:
- Get it wet. Nipple shields stay on your breast much easier if there is a little moisture to form a seal. You can either run it under water, or use your breast milk around the edges.
- Invert the shield. Fold the nipple shield so that the nipple is partway inverted. Then, place it directly over your nipple and seal it on to your breast. This helps draw out your nipple and get it closer to the tip of the shield.
- Breastfeed like usual. When breastfeeding with a nipple shield, try to keep breastfeeding as you would without one. Latch your baby on deeply to your breast because only attaching to the nipple won’t be effective to draw out milk.
- Clean after each use with soap and water. Keep your baby healthy and safe by cleaning your nipple shield after each use! Some moms also find comfort in sterilizing their nipple shields once per day by putting them in a pot of boiling water for 5 minutes.
- Possibly pump after feeding. Nipple shields can cause poor milk transfer which leads to all sorts of problems (like reduced milk supply and baby losing weight). If your breasts don’t feel empty after a feeding, baby didn’t make big swallows, or they act hungry then you my need to pump after feeding to express trapped milk and offer it to your baby (with a cup or bottle).
- Count your baby’s diapers and weight gain. To determine if your baby is getting enough milk, count their diapers. They should have 3 diapers per day for the first 6 weeks of life. After the first 6 weeks, their poops might decrease but they should still gain weight. Your pediatrician should weigh your baby every 2 weeks while you are using a nipple shield to ensure they’re getting enough milk.
Nipple Shield Sizing
Determining whether or not to use a nipple shield can be overwhelming in itself!
And now you have to choose what size of shield to use.
The good news is that there’s no strict rule for the optimal size… it’s dependent on each mom and baby.
Premature babies do better with a smaller nipple shield when breastfeeding. Try to find the smallest nipple shield you can that will still fit your breast.
Even if your baby isn’t premature, young babies might do better with a smaller shield.
As your baby grows, you will likely need to increase the size of the nipple shield (if you aren’t able to wean off of it).
Just try out different sizes- see which one fits you best and allows your baby to latch on deeply. Sometimes the first one you use will work well for you both.
There are also different shapes of nipple shields. Some are more pointy and triangular, others are more round and shallow. If one type doesn’t seem to be effective, there may be other options you can try.
If you can’t determine which size is best, reach out to a lactation counselor for help. Not only will they be able to help you determine which nipple shield is the best for you and your baby… they can also help with latch or breastfeeding problems you’re having.
Nipple Shield Breastfeeding Tips
Now that you’ve determined you need to try a shield and know how to use it, here are some tips for breastfeeding with a nipple shield!
Pay Attention To Your Breasts Throughout Feeding
This is super important! Using a nipple shield while breastfeeding can cause your milk supply to drop. Milk supply is dependent on demand.
Nipple shields can make it harder for your baby to express your breast milk while feeding.
If your baby isn’t getting enough milk, your supply can drop and your baby may lose weight.
To avoid this, pay attention to your baby and your breasts at feeding time.
Notice how full your breasts feel before a feeding and how full they feel after. You should notice a difference.
Also take note of how your baby acts during a feeding. Are they taking long sucks and swallowing? Pay attention to how your baby acts and see if it looks like they are getting enough milk.
Never Cut The Tip Of A Nipple Shield
You might hear people suggest cutting a nipple shield. Sometimes people will suggest it when weaning off the shield – cutting a little but each day until baby is not using it.
Maybe you’ve heard that cutting it will allow more milk to flow through…
NEVER cut a nipple shield!
Silicone becomes very sharp when you cut it.
If you cut a shield, your baby may cut their tongue, cheeks and lips while feeding.
This puts your baby at a risk for infection, and it can make them adverse to breastfeeding altogether.
Keep Your Baby Fed And Milk Supply Up
If you’re having trouble breastfeeding, these are the two most important things to remember!
Nipple shields should be used temporarily, so in the meantime make sure to feed your baby and keep up your supply.
Since nipple shields can interfere with milk transfer, your baby might not get enough milk. Also, if your baby isn’t removing enough milk from your breasts, your supply might drop.
In this case, pumping and supplementing might be necessary.
If you can’t wean off the shield and continue to have difficulty with your supply and feeding your baby – don’t be afraid to ask for help!
Best Nipple Shields For Breastfeeding
Truly the best nipple shield is what works best for you and your baby!
Hospitals have nipple shields in stock that you don’t have to pay out of pocket for, but you might find they don’t work as well as others. From my experience as a Lactation Counselor, this list is what I recommend.
1. Mamivac Nipple Shield (Cherry Shaped)
The Mamivac nipple shield is no doubt the best. It resembles a breast because of its unique shape. I find that it’s easier to wean babies off the nipple shield when it’s shaped more naturally.
The other thing I like about the Mamivac nipple shield is that it comes in different sizes. Most people probably wear a medium, but all moms are different. Some may need to order a small. If you have small nipples, using a small size will help wean off the nipple shield.
2. Lansinoh Contact Nipple Shield
The Lansinoh contact nipple shield is my second favorite. It’s shape is similar to the Mamivac shield and resembles the breast more than triangle-shaped shields. They also offer different sizes and are affordable.
3. Medela Contact Nipple Shield
The Medela contact nipple shields are the next best. They have a section cut out so your baby has more contact with your skin while breastfeeding. When you use this nipple shield, make sure your baby’s nose is right at where the shield is cut out. This is the nipple shield that many hospitals use.
Try out different types. Some babies might suck more efficiently with a longer or triangular shield. Other babies might do better with a cherry shaped shield if they have a small mouth.
I think generally the cherry shaped ones seem to be the most effective. They also tend to be easier to wean off, but like I said everyone is different so try what works best for you and your baby.
Permanently Using Nipple Shield
Are you wondering if you can permanently use a nipple shield?
Generally, it isn’t recommended but in some cases it might be the only option.
If you feel breastfeeding with a nipple shield is necessary, just keep in mind the two most important things: make sure your baby is eating enough and keep your milk supply up!
Some mommies don’t have any trouble with their milk supply while using a nipple shield.
Others find that they have to pump after every feeding session and offer their baby a bottle.
Each breastfeeding journey is unique, so don’t stress if you think you need to use a shield permanently.
I will stress though, that they really are supposed to be used short term. If at all possible, try to wean your baby off the shield.
Often babies will become stronger at breastfeeding, and don’t need a shield after the initial postpartum period. It might take some time, but weaning off the shield is the best option if possible.
If you find that you can’t wean your baby off the nipple shield 4 to 6 weeks after birth, reach out for help because there might be an underlying issue that needs to be addressed.
Do Nipple Shields Decrease Milk Supply?
Nipple shields generally have a negative effect on breast milk supply! This isn’t the case for EVERY mom, but it is the case for most. That’s the main reason why nipple shields aren’t recommended or should be used only temporarily.
If your baby has an issue that makes them unable to transfer milk effectively, a nipple shield won’t help the problem. Tongue ties and poor muscle tone will result in decreased milk supply so those issues should be addressed before starting a nipple shield.
Often with poor milk transfer problems, adding a nipple shield is just like a band-aid. It covers up the problem but it doesn’t solve it. And it can make the problem worse!
Before breastfeeding with a nipple shield, make sure there aren’t any underlying issues.
When using a nipple shield while breastfeeding, keep an eye on your baby’s weight and poopy diapers. That’s really the only way to know they’re getting enough. Then follow the steps below to wean your baby off the shield and get back to breastfeeding without one!
Weaning Off A Nipple Shield
Weaning off a nipple shield while breastfeeding isn’t always easy!
Babies can become dependent on using a nipple shield so be patient. With a little time and effort, you should be able to wean your baby off. It might happen overnight for some moms, but most need to work at it to wean their baby off successfully.
Steps To Weaning From Nipple Shield
1. Recognize Your Baby’s Hunger Cues
The first step to weaning your baby off the nipple shield is to recognize their hunger cues!
Feed your baby at the first sign of hunger. If your baby goes too long without eating, they will be upset and want milk more quickly.
It’s a bad way to start a feeding.
You want a happy baby when you start. Sometimes your baby will happily take the breast if they’re fed at the right time.
2. Make Sure Your Baby Is Comfortable
Starting a feeding comfortable is important! You need to make sure your baby is aligned correctly before attempting to wean off the nipple shield. Their ear, shoulder and hip should be in a straight line.
Make sure your baby’s head isn’t turned to the right or left. Their chin should be in a neutral position.
Just look at your baby and ask yourself if you would be comfortable eating in that position… that’ll tell you if your baby is comfortable!
3. Don’t Force It
If your baby starts to cry or become upset, don’t force it.
Just feed with the shield and try again next time… or tomorrow. Some babies need a little time to adjust and it’s important to keep times at the breast positive.
Another thing to consider is giving your baby time to adjust. Try removing the shield for just one feeding per day and gradually increase it.
4. Try The Bait And Switch
Sometimes the “bait and switch” is the secret to weaning off the shield!
Start the feeding with the nipple shield, and once your baby gets your milk flowing… quick as a whip take off the shield and pop them right back on your breast!
It doesn’t work for all babies.
But some have no idea what just happened! They just keep happily nursing.
Over time, do the bait and switch earlier in the feeding until you can just start a feeding without it.
5. Pump Before Feeding
For mamas with inverted or flat nipples, pumping before a feeding might help.
It also stimulates a let-down and gets your milk flowing.
Receiving milk instantly might help make your baby breastfeed without a nipple shield. Just pump for long enough to either feel a let-down or see milk start to come out.
Then, turn off the pump and latch your baby onto your breast.
6. Offer The Breast When Sleepy And Happy
Some babies are more inclined to breastfeed when they’re drowsy.
Usually the best time is right after they wake up from a nep when they’re still drowsy and the room is dark.
Offer your baby the breast without a nipple shield. They might just take it and start breastfeeding!
This often works well when paired with the bait-and switch.
7. Compress Your Breast Like A Sandwich
Another way to help your baby wean off the nipple shield is to compress your breast like a sandwich.
Nipple shields are easy for your baby to bring their mouth around and latch on to. If you have large or full breasts, your baby might have a harder time.
Try compressing your breast to help your baby latch.
You can release the compression slightly after they’re latched on, or continue to compress your breast during the feeding.
Just make sure you are only pressing hard enough to aid in your baby’s latch. Too much pressure can close off milk ducts, making it harder for your baby to draw milk and leading to clogs.
8. Try Suck Training
Another option you can try is called suck training.
In order to suck train before a feeding, wash your hands thoroughly.
Then, place your finger in your baby’s mouth upside down. Your finger pad should rest on your baby’s palette.
This helps your baby use the correct muscles for feeding, you’ll feel them moving their tongue and sucking on their finger.
You can slightly pull your finger out of their mouth and let your baby suck it back in.
Try suck training right before a feeding and then offer your breast. It might help your baby get warmed up and accept the breast without a nipple shield.
Even if it doesn’t work right now for your baby, suck training is still useful to tone your baby’s mouth, tongue and jaw muscles.
9. Express Milk Before Latching
Some moms find it useful to express breast milk before starting a feeding. You could do this prior to the bait and switch, or just try expressing milk onto your breast and offering your baby a feeding.
Express a few drops of breast milk onto your nipple and rub it into the skin and areola.
The smell of your breast milk encourages your baby to latch and breastfeed.
How To Use A Nipple Shield: Video
Conclusion: Breastfeeding With A Nipple Shield
Breastfeeding with a nipple shield comes with all sorts of questions! It’s so important to know why and how to breastfeed with a nipple shield.
I hope this guide helps you determine if you need one and the best way to use one for you and your baby!
I love helping moms breastfeed so if you have any questions please reach out to me. You can find me at www.littlebearcare.com.
Kealy Hawk, BSN, RN, CLC
Kealy is a Registered Nurse, Lactation Counselor, and most importantly a mommy! Her own baby feeding struggles gave her a passion to help moms throughout their feeding journey. She specializes in breastfeeding support and evidence-based formula recommendations. To talk with Kealy or take one of her breastfeeding or formula classes, visit https://littlebearcare.com.