Should I stop using nipple shields?

[KatsMother28]

Hi there,

I know there's probably dozens of threads covering these issues but short of trolling through all the posts I can't seem to find what I'm looking for.

My DD is 6 weeks old on Wednesday and I'm so conflicted over feeding I just don't know what to do. I was always determined to breastfeed her as I really want to give her the best I can but it's starting to really get me down. When she was first born the mws wouldn't let me out of hospital for 3 days as they were concerned I wasn't able to feed her properly - despite them all looking and confirming the latch was good it was excruciating from start to finish. when they finally let us out she dropped 9.9% of her birth weight in 3 days.

After a week or two a mw gave me nipple shields to try and the pain stopped instantly - I was able to feed her more often and for longer and she piled the weight on. Now though I keep being told I should stop using them and try without even though the pain starts again straight away and makes me want to give up.

It's getting me down enough that I don't get a break of more than 3 hours as I can't seem to express enough for anyone else to feed her but if I have to be in pain as well I really will lose it. I'm being referred to the postnatal team for depression as it is.

Please can anyone tell me a good reason why I should stop using shields?

No reason at all. Don't listen to any pressure from HVs to stop using them. They will tell you that it reduces the amount of BM that is produced, and leads to your milk drying up early, but this is simply not true. This advice is based on old studies/ anecdotal evidence from many years ago. Nipple shields have advanced significantly since then and recent studies now show there is no difference in milk yield with or without shields.

I have a bit of a bee in my bonnet about this (can you tell?!) because I spent the first 3 months of my DCs life worrying and feeling incredibly bad for using sheilds, when what I actually should have been doing was enjoying the fact that I could now successfully BF him. It was a very tough time and the added unnessecary (and frankly, completely misinformed) guilt in the shape of advice about not using shields added 1000% to it.

You're doing so well to BF, good luck with it all.

Have they ascertained WHY it hurts so much? Has your DD been properly assessed for Tongue tie/Lip tie? It doesn't matter if it looks good if it hurts so much.

Have you had your breastfeeding assessed and help given to improve latching on and the positioning and attachment? Has anyone suggested biological nurturing (aka laid back nursing)?

When you bf without the shields what happens to your nipples? Do they change shape or colour (lipstick/bullet shaped/ridge running from the base of the nipple to the tip on both sides or purple/white)?

If you are in so much pain that you can't bf without the shields then keep using them but do try to get in contact with a bfing specialist MW/Infant feeding co-ordinator/BFing Counsellor/IBCLC to get a proper full assessment of your bfing.

Hi Truthsweet

I've been trying to access other help in my area but my HV is next to useless at signposting me the best she's offered is a phone call from the head HV who has expertise in BF. I've been to the local Surestart and spoken to a peer supporter who just said it was normal and by persevering it'll stop but it's so painful all the time.

I don't think she's tongue-tied as I've looked into it and she has none of the signs and can stick her tongue out quite a way. I'd like a professional to look but again there are none in the area

My nipples usually come out looking rugby ball shaped and white and DD usually still seems hungry and frustrated at which point I fish out the nipple shield again!

Thanks Bill's - that does make me feel better to know I'm not alone with the guilt.

If they are squashed and white that suggests the nipple is being compressed against the hard palate not the junction of the hard and soft palates (further back in the mouth). Does it hurt more or continue to hurt post feed, especially when the nipple goes back to it's normal colour (vasospasm)?

Why she is coming off hungry, is because the flow is restricted by the tongue pressing the nipple against the hard palate leaving her with less milk. Does she 'chomp' or bite down on your nipples as well, or slide off multiple times during a feed (when not using shields)?

I'm shocked though a peer supporter would say that what you are experiencing is normal and to persevere - I'm a peer supporter and I know that the kind of pain you describe and the changes to your nipples are not normal at all! If I had met you in our local children's centre I'd be referring you to the TT clinic for a proper assessment (okay, I'd be begging a HV/MW to refer you as I can't!) as there are signs that a TT exists (not for definite though but worth getting it checked out). Unfortunately being able to stick her tongue out doesn't definitively rule out TT.

Have you tried deep latching technique before (aka exaggerated latch/'the Flipple')? That can work to get a good deep latch and can avoid the tongue compressing your nipple on the hard palate.

Really don't feel guilty because you use shields, it sounds like you have been let down by both the MWs at hospital telling you all looked 'good' (it may look good but it didn't feel good for you) and by the PS telling you to persevere as it was normal!!

I agree with bill based on my experience so far. I have used them since DD was 30 hours old. She just will not latch without them as my nipples are flat.

It's not ideal and the BF counsellor and I have tried everything to wean her off them to no avail. In the end we have just agreed that I've tried and tried, she is happy and gaining weight and I'm enjoying feeding her so lets stop stressing about it.

I think Kellymom makes the point that breastfeeding with shields is preferable to not breastfeeding and that's how I feel about it.

If you haven't already try Medela contact shields. They are half shields so you still get skin to skin.

I really can recommend the flipple technique. My DD had a non-obvious tongue tie and I had huge pain, distorted nipples vasospasm, but she also clicked constantly and couldnt stick her tongue out - but anyway the flipple saved our breastfeeding relationship for 6 months until someone diagnosed and snipped her tongue tie.

Well worth a try even if it's not tongue tie as it just helps attachment...

I cant see any reason to stop using them if you are both happy. Using them and continuing to bf is surely preferable to not being able to bf. I too experienced some negative comments from midwife, hv etc about their use. My dd was born at 32 weeks and was just unable to latch on so I have used them from birth ( she is now 5 months old and we are still using them!). I also know a few other mums using them. None of us have experienced problems with poor milk production and after a bit of practice it becomes easy using them to bf in public. The only negative thing I have experienced is that just occasionally dd gets frustated I think because of the slower milk flow through them and sometimes it does seem to take ages for her to finish her feed which again I think is due to the slower flow through the shield. I read a lot of posts on here from people who were using them and it seems that as their babies got older a lot of them just knocked the shields off and carried on feeding without. Im still waiting!!
As its still early days for you I definitely think its worth getting your latch checked etc. have you got a LLL group that you could go to? However personally I wouldnt worry if you continue to use the shields, they are not all that bad!
Good luck and I hope things get better for you

Disclaimer : I am not a professional! But i did use nipple shields for a lot of the year that I fed dd. I couldn't have done it without them, they were fantastic. We were both happy, I managed to bf more than a month and no problems arose . No regrets here.

I can't give you a good reason to stop using them because for me, they've allowed me to start BF when other avenues proved tough. This is so similar to my situation I'm currently in. Except rather than having to stay in hospital for longer than I wanted, I left 3 hours after delivery and got zero breastfeeding support ...

I have flat nipples and had to formula feed the first few days which I really didn't want to do because I was getting nowhere with latching on. Rang NCT helpline (midwives crap) and they said try nipple shields initially, I did, and it's worked a treat.

My midwife today (a good one - hurrah) said pretty much what pastabee refers to - that it's better to BF with shields, if that's what you want and works for you, than to be a martyr and risk giving up because it's too hard / painful etc.

I'm trying starting with them, then removing and continuing whilst nipple is bigger but I am of the view that (a) it's your own choice what to do and you shouldn't feel guilty and (b) if it works for you and your baby, go for it.

I've been using shields since we got re-admitted at 5 days after at 16% weight loss. IMHO they are a god send.

I was advised by a MW to try to stop using them, but the HV said if it aint broke don't fix it! LO is now 4 weeks, back over birth weight and gaining weight in line with whatever percentile curve we was nearest. I am changing nothing unless that changes.

That said, I was waiting to steralise said shield and offered a nipple in a bid to calm him and he latched straight on. Didn't work on the other boob though

I've posted about this elsewhere but I used nipple shields from birth to 8mo with DS as he couldnt latch on/my nipples deemed to be too flat by MW's. No issues with supply. He was massive.

Currently doing the same with DD due to tongue tie initially and initially thought we were going to have to use nipple shields for the duration again, but then I just stopped using them one day at 3mo and she didn't object one bit. Obviously my nipples have improved with age!

So now I don't have to bother buying/replacing/sterlising/transporting in sterile container when out/ nipple shields, which is REALLY nice, but apart from that, no earthly reason to stop if it's helping you breastfeed your baby. As Kitty says, if it ain't broke,don't fix it!

Thanks everyone, there's some really encouraging posts here. I'm being visited by another HV tomorrow to see if she can help but I've made it clear to her that if it's a choice between using them or be in pain I'm going to keep the shields because I don't think it will do me or my baby any good for me to dread every feed.

I have tried the flipple (I think) but as I'm not sure I'm doing it right it's hard to say if it makes a difference - will mention it tomorrow and we'll see what she says.