Login

Blog Archive

Blog Archive


Nipple Shields

November 2015

For the month of November, the Thursday Truth series will focus on various breastfeeding devices in order to better assist you in choosing the appropriate tool and using it correctly. This week, let's discuss nipple shields.

Nipple shields, devices worn over the breast DURING a feeding, have been found in recorded history in one form or another for at least 500 years. Originally made of pewter, bone, wood, lead, glass, and even animal skins, they have changed through the decades.

The 1950's to mid 1970's found the shield designed out of thick rubber, which research showed decreased the effectiveness of milk transfer by the baby. Only 20 years ago, I was able to buy a nipple shield of glass and rubber in a little pharmacia in Nuevo Laredo, Mexico for less than $2.00---certainly not a good device to use for milk transfer or nipple protection!

The new silicone nipple shields currently on the market seem to have the least negative effect on milk supply and milk transfer, if sized and applied correctly. Keep in mind the basic principles for milk transfer: the breast should be compressed, negative pressure provided to assist the breast in pushing milk out and into the baby, and the latch should be deep enough to prevent nipple compression at the anterior oral space, which can lead to nipple damage and pain.

When applying the shield, size really does matter. Lactation consultants used to size the shield according to the infant's mouth. However, we now suggest sizing the shield according to the maternal nipple, as we want as much of the nipple tissue inside the shield as possible to meet the principles of milk transfer. With that in mind, there are several ways to apply the shield to the breast. This video is pretty close to the method I have developed over the years:

This technique is not included in the instruction handout for any of the brands of shields on the market (at least not that I've been able to find). So without correct teaching regarding the how-to's and the why's of effective application, mothers may report nipple pain and damage, reduced milk supply, and slowed weight gain or even weight loss by their baby.

Here is a link to a free downloadable research overview on nipple shields: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014757/pdf/bfm.2010.0003.pdf

When should you use a nipple shield? Research has demonstrated an advantage for premature infants and some late-preterm infants, as the shield keeps the nipple well-placed in their mouths and they expend less energy having to regather and maintain the latch each time they relax the negative pressure in the oral space. Mothers with truly inverted nipples or those with flat nipples but non-compressible breast tissue, making the formation of a 'nipple sandwich' impossible, might benefit from a shield also. Although they are advertised by many manufacturers as a "quick fix" for sore or damaged nipples, without determining why the pain or damage was created in the first place, they usually will not resolve the problem and in some cases, they will actually make it worse.

Shields should be used under the direction of an International Board Certified Lactation Consultant. If a shield is given to mothers during the brief hospital stay, post-discharge follow-up by an IBCLC is a must. Frequent infant weight checks should be done, assessment of the maternal milk supply provided, and nipple pain evaluated. NEVER should a nipple shield be dispensed to a newly postpartum mother without a full discussion and demonstration of correct application and follow-up. And never, never, never use a bottle nipple over the breast in place of a nipple shield.

Sources for nipple shields are many, and there are a few features you might want to evaluate prior to using a particular brand. First, how many sizes are available? We all know that all mothers are not built the same, and even the same mother may have two very different breasts and nipples. Second, what is the shield made from? Latex is not recommended due to the allergen potential. Third, put your hands on the shield: try stretching it, turn it inside out and feel for roughness at the very tip of the interior side. Remember the maternal nipple should be as deep into that shield tunnel as possible; if there are raised areas (and there are several brands with those!), mother's nipple tip has the potential to come into contact with that area, leading to abrasion, bleeding, and potentially premature weaning.

What have you found to be some of the benefits and detriments to using nipple shields in your facility? How do you provide follow-up following discharge? Share to everyone to benefit from!!

Kathy



Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA
Course Tutor, Step2 Education

 

 

 

 

Remember me Login Logging in...
Submit Sending... Sent! Clear
Submit Sending... Sent! Clear

This Privacy Policy describes how your personal information is collected, used, and shared when you visit or make a purchase from https://step2education.com (the "Site").

PERSONAL INFORMATION WE COLLECT

When you visit the Site, we automatically collect certain information about your device, including information about your web browser, IP address, time zone, and some of the cookies that are installed on your device. Additionally, as you browse the Site, we collect information about the individual web pages or products that you view, what websites or search terms referred you to the Site, and information about how you interact with the Site. We refer to this automatically-collected information as Device Information."

We collect Device Information using the following technologies:

  • "Cookies" are data files that are placed on your device or computer and often include an anonymous unique identifier. For more information about cookies, and how to disable cookies, visit http://www.allaboutcookies.org.
  • "Log files" track actions occurring on the Site, and collect data including your IP address, browser type, Internet service provider, referring/exit pages, and date/time stamps.
  • "Web beacons," "tags," and "pixels" are electronic files used to record information about how you browse the Site.

Additionally when you make a purchase or attempt to make a purchase through the Site, we collect certain information from you, including your name, billing address, shipping address, payment information (including credit card numbers), email address, and phone number. We refer to this information as "Order Information."

  • Users who are undertaking a course as part of a group or organization have certain data tracked as part of the service we provide to Clients and Facilitators. This includes information showing if you have logged in and when, dates of completion and what and when particular study topics, resources and assessments were viewed and completed. We refer to this information as "Student Access Information"

When we talk about "Personal Information" in this Privacy Policy, we are talking about Device Information, Order Information and Student Access Information.

HOW DO WE USE YOUR PERSONAL INFORMATION?

We use the Order Information that we collect generally to fulfill any orders placed through the Site (including processing your payment information, arranging for shipping, and providing you with invoices and/or order confirmations). Additionally, we use this Order Information to:

  • Communicate with you;
  • Screen our orders for potential risk or fraud; and
  • When in line with the preferences you have shared with us, provide you with information or advertising relating to our products or services.

We use Student Access Information to provide accurate tracking to Users and Clients on completion and use of the courses, as well as for analysis on how to improve our services.

We use the Device Information that we collect to help us screen for potential risk and fraud (in particular, your IP address), and more generally to improve and optimize our Site (for example, by generating analytics about how our customers browse and interact with the Site, and to assess the success of our marketing and advertising campaigns).

SHARING YOUR PERSONAL INFORMATION

We share your Personal Information with third parties to help us use your Personal Information, as described above. For example, with your employer who needs to verify your completion or progress of your studies. We also use Google Analytics to help us understand how our customers use the Site--you can read more about how Google uses your Personal Information here: https://www.google.com/intl/en/policies/privacy/. You can also opt-out of Google Analytics here: https://tools.google.com/dlpage/gaoptout.

Finally, we may also share your Personal Information to comply with applicable laws and regulations, to respond to a subpoena, search warrant or other lawful request for information we receive, or to otherwise protect our rights.

BEHAVIOURAL ADVERTISING

As described above, we use your Personal Information to provide you with targeted advertisements or marketing communications we believe may be of interest to you. For more information about how targeted advertising works, you can visit the Network Advertising Initiative's ("NAI") educational page at https://www.networkadvertising.org/understanding-online-advertising/how-does-it-work.

You can opt out of targeted advertising by:

Additionally, you can opt out of some of these services by visiting the Digital Advertising Alliance's opt-out portal at: http://optout.aboutads.info.

DO NOT TRACK

Please note that we do not alter our Site's data collection and use practices when we see a Do Not Track signal from your browser.

YOUR RIGHTS

If you are a European resident, you have the right to access personal information we hold about you and to ask that your personal information be corrected, updated, or deleted. If you would like to exercise this right, please contact us through the contact information below.

Additionally, if you are a European resident we note that we are processing your information in order to fulfill contracts we might have with you (for example if you make an order through the Site), or otherwise to pursue our legitimate business interests listed above. Additionally, please note that your information will be transferred outside of Europe, including to Canada and the United States.

DATA RETENTION

When you place an order through the Site, we will maintain your Order Information and Student Access Information for our records unless and until you ask us to delete this information. We are required to keep course completion records for at least 5 years in order to comply with certain accreditation requirements.

CHANGES

We may update this privacy policy from time to time in order to reflect, for example, changes to our practices or for other operational, legal or regulatory reasons.

CONTACT US

For more information about our privacy practices, if you have questions, or if you would like to make a complaint, please contact us by e-mail at info@step2education.com or by mail using the details provided below:

5890 Monkland Avenue, #16, Montreal, QC, H4A 1G2, Canada

Last Updated: September 2018