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Thread: Nipple shield question

  1. #1

    Default Nipple shield question

    I have flat nipples and in the hospital they gave me a nipple shield and I also worked with one of the lactation consultants. She showed me how to turn the medela shield partially inside out to draw out the nipple. It worked great at first but after I got home the shield seemed too soft and doesnt work anymore. I still use it at every feeding because my nipples are still flat. My question is..am I supposed to use the shield during the whole feeding or try to take it off after she latches? And will I need to use the shield her whole breast feeding life or will my nipples eventually stick out enough that I wont need it? Thanks for your time!

  2. #2
    Join Date
    Jun 2009
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    10,754

    Default Re: Nipple shield question

    Hi and welcome! How old is baby now? How long have you been out of the hospital?

    Nipple shields are typically a TEMPORARY solution to a baby not being able to latch. Also, Lots of babies latch just fine on "Flat" nipples. So no, this is not likely to be a tool you need forever. Did the LC show you various latch techniques, nursing positions, etc, trying to get baby to latch better without the shields? Can you see another (or the same) IBCLC now? Things change rapidly and it is possible that with the right latch techniques you could wean off the shield now.

    When you say your nipples are flat- is this something you have always seen about your anatomy? Or just after baby was born? Do (or did) your nipples ever respond to stimuli by getting harder? Are you very full or engorged between nursing sessions? Did you get lots of IV fluids or are you noticing any swelling from edema in your hands or feet or face? Are you in pain or on narcotic or very strong pain meds?

    IS baby gaining ok? Pooping lots? Is nursing comfortable for you?

    If your baby can latch and nurse without the shield, do not use the shield. Flat nipples do not always require a shield. If baby cannot latch without the shield, then use it but of course you do not want to use it forever. So keep trying to see if baby can latch without it, as much as you like. You don't have to try without it at every feeding, but maybe at least a couple times a day? It can be during a feed, (at a pause or whatever, unlatch baby, take off the shield, and try to get baby on without it) or just try at the next session, whenever. I am not sure how you would take a shield off while baby is actively nursing....???? Have you done that? Because that would be a cook trick if it worked.

    As far as the shield not feeling the same- Was the shield washed with very hot water or strong detergent or something? These should last a very long time....Maybe the size is no longer right for you? IN any case, they are not all that expensive and can be found at baby stores or even Target, although the selection is limited. And of course you can buy them online. So if you want to new one, you can probably get it.

    More: Nipple shields: http://kellymom.com/ages/newborn/nb-...s/wean-shield/
    Latch and positioning ideas- an overview: http://feedthebabyllc.com/latch-and-positioning/
    What is involved in a lactation consultation with an IBCLC: http://www.cwgenna.com/lconsult.html

  3. #3

    Default Re: Nipple shield question

    Thank you!
    My baby is 14 days old today. She got latching pretty quickly I think. I was in the hospital for three days. The LC showed me two feeding positions..the front and the sideline. She showed me how to roll my nipple to make it more erect but it wasnt working so we moved on to the shield.

    No, my nipples were always flat or inverted. Many years ago I went to an obgyn who told me I had inverted nipples and would half to work much harder at breast feeding one day. I didnt even know what inverted nipples were or that mine werent normal. The hospital nurses said they are flat rather then inverted. My nipples sometimes respond to stimuli but not all the time. I am engorged between feedings and I pump now because I have painful blocked ducts. I did get a lot of fluids at the hospital but all the swelling has gone down since delivery. The only meds I took after the birth was the ibprofin and stool softener. I had a vaginal birth with 3rd degree tear.

    Last week the baby hadnt gained all her weight back yet..but I was also feeding her on a 3 hour schedule. My milk came in on day 5 also. Now I feed her on demand and she feels heavier and looks like she has gained weight. We have another doc appt on thursday to check her weight. Nursing is comfortable for me now. She seems to get a good latch now that isnt painful..but that is with the shield. We now need to practice not using it.

    Haha yes I will try at least a couple times a day to get her to latch without the shield using the techniques on the link you gave me. Her doctor told me to feed her 7 minutes each boob and switch back and forth so that may help get my nipples erect in the begining. She recommended that because I told her the babies poops were green when I would have her nurse on only one side at a time. Since Ive changed to 7 minutes each boob my babys poops are yellow again.

    I wash the shield after each use with hand soap in hot water. The directions say to use hot water. I bought two more and the extra medela one I bought is the same. I cant get it to work like at the hospital anymore, not even the brand new shield. But the older one is way softer then the newer one.

    Thanks for your help!!

  4. #4
    Join Date
    Jun 2009
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    Default Re: Nipple shield question

    Ok, thanks for the reply. There are many ways to try to get a better latch, and many different positions to try, so I do suggest keep working on that. Additionally there are tools that can be used for your issue specifically. Some moms find that pumping helps bring out the nipple, but you just do not want to express too much milk or you risk overproduction which will make things harder.

    Additionally there is this tool: https://www.lansinoh.com/products/la...nipple-everter

    Inverted nipples means that when you squeeze your breast (gently) behind your nipple, the nipple inverts more rather than everts. At least that is the technique I know of for telling the difference.

    Engorgement makes a flat nipple much more flat. So you want to avoid this as much as you can. Did anyone show you reverse pressure softening to help baby latch when the areola is swollen from being engorged? I will link info below. What with plugged ducts and all, I really wonder if you can see an IBCLC as an outpatient for a full consult. Plugged ducts are also helped if baby can latch better, avoiding engorgement, avoiding latch pain, etc- It all comes back to getting the best latch possible and baby transferring milk well.

    I am glad you are feeding baby on cue. Schedule feeding will only increase the issues you are having. However, this is maybe not so good:
    Her doctor told me to feed her 7 minutes each boob and switch back and forth so that may help get my nipples erect in the begining. She recommended that because I told her the babies poops were green when I would have her nurse on only one side at a time. Since Ive changed to 7 minutes each boob my babys poops are yellow again.
    Timing baby on the breast tends to be exhausting and not natural and tends to cause all kinds of issues. Plus if you have just spent ages getting the nipple shield right and baby latched, isn't it frustrating to switch sides 7 minutes later?

    Also, switching baby back and forth like that is a milk production increasing technique...so could actually be contributing to engorgement. On the other hands, green poops especially in the early weeks are entirely normal and do not really require any intervention. I am not going to say do not time baby on the breast anymore if you feel it is helping, but I am concerned this might lead to more issues.

    In general, newborn infants will nurse at least 10-15 times a day, with some parts of the day way more frequent nursing than others. Nursing one side at a time at some or all sessions is usually fine. Babies like to nurse as long as they like to nurse, some sessions will naturally be longer than others, and there is no reason to limit time at the breast. Cue feeding means feed baby at earliest cues and also, mom can offer to nurse whenever she likes- as soon as she starts feeling full, for example.

    Nursing a baby with high frequency and letting baby decide (with input from mom depending on how your breasts feel) how long and one side or two goes a long way to preventing issues like engorgement, nipple pain, poor latch, poor gain....

    I am trying to remember when I used a shield with my oldest. I do not recall it not working right or getting much softer, a little maybe, but not enough that it did not work well anymore. So I am not sure what is going on there. I do remember you have to turn it really inside out and center the tip over the nipple to get it on, and it can be quite fiddly, and when my milk leaked on it it always slipped off and I had to dry off and start all over. But I think I only rinsed it in warm water from the sink, and used very mild soap or just rinsed it- I know I never boiled it, I was told not to by my LC- but it says to boil it on the Medela website! So I do not know. Maybe call Medela?

    RPS and engorgement: http://www.lalecheleague.org/faq/engorgement.html

  5. #5

    Default Re: Nipple shield question

    Thank you again so much for all the info and wisdom. I odered the everter and I am going to look into seeing an IBCLC hopefully my insurance will cover it.Do you think pumping adter each feeding is still a good idea for the lumps? My daughter never empties my breasts but I also dont want to add to the issue.

  6. #6
    Join Date
    Jun 2009
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    10,754

    Default Re: Nipple shield question

    That is a hard question to answer. Pumping increases milk production, and so pumping if you are getting plugs and engorged certainly can lead to more of the same. On the other hand, the more immediate issue is the engorgement and the plugs, because those can lead to mastitis and that can make you feel quite ill.

    My best suggestion is to try the many strategies for dealing with plugs and engorgement that do not involve pumping, and then pump if and when needed.

    As far as emptying the breast, this is not needed on a regular basis as long as baby is nursing often and gaining well. Most of the time, moms make a little (or a lot) more milk than baby needs at this point, so a baby will not typically "empty the breast" and also, since the body is always making milk, the lactating breasts are never truly empty.
    What is possibly complicating this also is the shields themselves, as they may be impeding milk extraction somewhat.
    What you might try is to get lots of milk out at once ONE time- (or as many times as needed, but not every nursing session- maybe once a day if needed) by letting/encouraging baby to nurse a long time, and then pumping or hand expressing (or both) as needed, and if that does not do the trick for getting rid of the plugs, try some vibration or something to break up the plugs and nurse again.

    Here are some good articles on plugs: http://kellymom.com/bf/concerns/mother/mastitis/ and http://www.llli.org/docs/00000000000...plugsblebs.pdf

    As far as seeing an LC, I do recommend it. Call around, you might find that paying out of pocket for an LC is not as bad as you think. Also there may be a low cost clinic in your area.

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