I have those days where I feel like all of my clients need a shield. And for just a minute, I hesitate. Does this mom really need one? Does the baby need one? Is this a crutch? Will it cause problems down the road? And then I get over it and get the shield. Some moms have inverted, flat or short nipples. But even these moms may be able to breastfeed without the shield. Sometimes the baby has a tongue tie or just can't quite grasp the 'suck, swallow, breathe' yet. How do we know if a shield is needed? Here's the scoop: If a baby goes to the breast repeatedly and cannot sustain the latch, regardless of the nipple, a shield may help. Imagine the shield as training wheels on a bike. Sometimes that's the easiest way for the baby to learn. Sometimes it is the easiest way for a mom to learn. It is a tool in her toolbox that she can utilize when the baby isn't staying latched.
So what's the problem with the shield? Many moms, like me, hesitate. We think about the shield as a bother. Something we have to drag around everywhere we go and separating our baby from the breast. I want to stop you right there! Not every mom needs a shield. Nor every baby. And sometimes not every feeding. But it's a tool. Thank goodness we have tools!!! They help fix things, sometimes just temporarily. Sometimes permanently. But at least we have options! 2 AM can seem pretty scary if you have a hungry baby that doesn't stay latched.
There are some great YouTube videos on how to place the shield. (you are going to see someone's nipple...it's okay!) To get the correct size, look at the size of your nipple. Is it fatter than the tip of your pinky finger? Go with the 24. Is it smaller than the tip of your pinky finger? Go with the 20. The nipple shield size is based on the size of your nipple, not the baby's mouth.
To place the shield on, first hold it with both hands. It looks like a hat. Gently pull the shield to stretch it slightly, and then with your fingers or thumbs, push the top of the hat. The shield should look halfway inside out. Place on your nipple and push in until the hat pops out again. Voila. You did it. Now don't compress your breast. This is the one time we say that. Just place your fingers on the shield so that your baby's octopus arms don't knock it off. Then bring the baby to your breast like normal. Yes the milk can come through.
After feeding you can hand express for a few minutes or pump to get extra stimulation. But only if it makes sense for what you have going on that day. I definitely want you to get some rest! You will know when you are ready to start weaning from the shield when your baby has 2 consecutive feeds where they come on and stay latched for the entire feed. Start with the shield on and after a couple of minutes, detach your baby, compress your breast and bring him back on...quickly! Did he stay on? Fabulous! Did he start sliding off? Not ready. Put the shield back on, tell yourself you are amazing and try again tomorrow. It may take some time. Remember to give yourself grace. And if you need help reach out to a lactation consultant...this is what we do!