What is a Breast Shield? Why Would I Need One?
What is a breast shield and why would I need one? These are common questions. You hear breast shields (or – nipple shields) discussed among friends. You hear them whispered about, little traces of their name with an implication of importance, and often, without the necessary details.
You May Ask….
What is a breast shield? Why would I need one?
Are they covers to keep my breast from rubbing against my shirt?
Are they nipple covers that, when worn over time, will evert my nipples?
Are they the pieces that fit over my breasts when I use my breast pump?
Once I use one can I ever nurse without it?
An Important Thing to Understand Before Absorbing This Information…
Please have faith that you can nurse without accessories. Believe that there are many techniques to try before needing a shield. Use professionals to help you. Don’t by a shield before you have met your baby – if you find you need one get it then. Don’t let the existence of shields make you think you won’t be able to nurse without one. Keep all this in mind. Keep positive- and THEN- if you still need the shield then use it wisely and cautiously with guidance.
What a Breast Shield Is and Is Not
Breast shields aren’t related your breast pump, they can evert your nipples, they are NOT worn in your bra to evert your nipples, they are most often used temporarily.
A breast shield is a tool that mothers use and lactation consultants may recommend to help latch a baby to the breast for nursing. They are made from silicone,latex or rubber, they are flexible, and they are placed over your nipple and “extend” your nipple. When I say “extend” I mostly mean it in the sense of something like hair extensions where part of you hair is involved then false hair is connected to make it appear longer. Your nipple fits inside a bigger nipple (the shield) and the shield acts as a “false” nipple allowing your baby to feel something in his or her mouth that lets him know it’s time to nurse. It also “extends” your nipple. Once your baby is latched onto the shield and sucks, he draws your nipple out and extends it within the shield.
There are holes at the tip that allow your milk to escape and flow into the baby’s mouth.
Reasons Breast Shields are Used
Breast shield for Flat or Inverted Nipples
Breast shields are used when flat or inverted nipples are an obstacle to successfully latching your baby. Some mothers with flat and inverted nipples can nurse without a shield, some need a shield in the first few weeks.
OF NOTE: Babies need to feel something on the roof of their mouth in order to nurse well. If you place your pinky into your baby’s mouth and stroke the roof of the mouth – your baby will begin to suck. It’s a reflex – called the suck reflex. Parents who try and try to wake their sleepy newborn to nurse may discover it is very difficult to get them to nurse. Especially if, after shaping the breast multiple ways to get it into the baby’s mouth to elicit the suck reflex, the baby continues to keep his mouth shut and sleep. This is a real challenge. This can sometimes occur if the nipple is not everted and the baby struggles to feel it.
When a breast shield is used due to flat or inverted nipples it can allow your baby to feel a nipple in his or her mouth and the nipple will become drawn out. A mother may be able to use the shield briefly to draw the nipple “out” then take the shield away and get the baby to latch onto the nipple that is now “out” without actually using the shield for the entire feed. OR, if the nipple does not get drawn “out” enough to really get the baby to feel it and suck- then the shield can continue to be used throughout the whole feeding.
Breast shield for Premature, Small or Ill Baby
As mentioned – babies need to feel something in their mouth in order to nurse well. Preterm babies (including late preterm up to 37 weeks), small babies or ill babies may struggle to feel the nipple simply because they do not have the strength and coordination to position the breast in such a way as to feel it. Term babies (38 to 40 weeks gestation) are often aggressive enough to get a nipple into their mouth deeply.
In order to get these babies to nurse a shield is used as a “training wheel” to get them started with the aim to “wean” them from the shield once they are more strong and coordinated.
Breast Shield For A Baby That was Fed by Bottle
Sometimes a baby gets a bottle in the hospital. Usually due to medical indications such as jaundice, low blood sugar or poor weight gain. Once they receive milk in this way they can become used to the feel and flow of this nipple and reject the breast. A nipple shield can be a bridge to get the baby onto your chest and breastfeeding again. If your breast milk supply has dropped then a lactation consultant may recommend an SNS (a supplemental nursing system) in order to help in these situations. This is where a flexible tube filled with milk lays against the breast and inserts into the breast shield. As the baby nurses the milk is drawn out of the tubing and the baby is motivated to continue nursing. Usually as the milk supply increases the tubing is discontinued and then the shield as well.
OF NOTE: If you find that your baby needs a supplement due to a medical indication you can ask if there is another way to provide the supplement other than by bottle. You want to preserve your breastfeeding relationship. Don’t be afraid to speak up.
Breast Shield for Traumatized Nipple
An incorrect latch damages nipples can making them cracked, bruised and blistered. Occasionally a breast shield protects the nipple throughout the feed until it can heal. This sometimes helps and sometimes does not.
Breast Shield For Engorgement
When your mature milk develops on day 3 your breasts can become so full and taut that the baby can not get a grip on your breast. This is engorgement. It’s like trying to make out with a basket ball. Difficult. The shield can be used for these times though it is often more worth while to hand express some of your milk to soften the areola.
Breast Shield for Tongue or Lip
If your baby is deemed to have a tongue or lip tie by a professional it may mean that they struggle to keep the nipple in their mouth. Even with an everted nipple. If you are against the treatment of tongue tie or are awaiting your baby to be evaluated by an ENT or pediatric dentist for this problem – the shield may allow you to nurse your baby.
Breast Shield for Forceful Let Down
Sometimes when your milk supply is fully in and your let down is very strong your baby will pull away and choke and cough when nursing. Sometimes mothers use a shield to help control the flow of milk to allow the baby to catch a breath and nurse comfortably. There are also other ways to help with this other than with a shield.
A Breast Shield When Baby Doesn’t Latch
Maybe you have everted nipples and your baby is full term but latching still isn’t going well. You may figure out why. Maybe you’ll never know why it didn’t work but you need a shield to get breastfeeding going. Having a baby that doesn’t latch is like trying to catch a ball in a very very long game of catch. You just want to catch the F****** ball already!!!! Once you get through birthing your child it’s your next most important goal. If 10 hours go by without success it can be nerve-wracking and frustrating! A shield might help save everyone’s sanity here. For Tips on latching go to:http://roothomebreastfeedingri.com/3-tips-for-a-successful-latch/
THERE WILL ALWAYS BE OTHER REASONS NOT LISTED HERE.
Risks and Benefits of Breast Shield
The risks of using a breast shield are: your baby adapts to it and you are unable to breastfeed without professional support to “wean” your baby from it.
Another more important risk is that your baby latches poorly with the shield and this impacts your milk supply for the worse. If latch is incorrect it also impacts your baby’s weight. It is paramount that the latch is correct, your baby gains weight and your breasts fully drain when you nurse. It is a MUST that if you are using a shield you also have a lactation consultant overseeing your care.
The benefits- You breastfeed your baby where otherwise you would not be able to.
Before You Use a Breast Shield
Use One-on-one assistance by a knowledgeable lactation consultant. Have them help you by: Assisting with your latch. Seeing if using a pump can help draw out flat nipples. Shaping your breast in different ways to get baby to latch. Keeping baby skin to skin as often as possible. When you use the shield seek a professional to help you wean from it once the underlying problem is resolved. See Breastfeeding holds blog: http://roothomebreastfeedingri.com/breastfeeding-holds-you-may-not-have-thought-of/
Have faith in the body you were born with and the instincts of your baby. These are powerful things that need no aid most of the time. We are mammals – it is in our DNA to have babies and to nurse them, as it is also in a baby’s DNA to scramble to the nipple and suck well. There are so many things to try before reaching for a shield. Exhaust those options first. Remember – resist the urge to buy a shield when you are pregnant. It’s so easy to get lost in the world of things. Always, always seek educated support if you find yourself needing a shield. Happy breastfeeding!
Make an appointment for in person or Skype lactation consult at: http://roothomebreastfeedingri.com/appointment-booking/
Witten by Aimee Quigley RN, IBCLC