Breastfeeding: Use of Nipple Shields

Used appropriately, nipple shields may be useful for some mothers and babies. Always contact a lactation consultant or your healthcare provider before using a nipple shield to determine if a nipple shield would be appropriate. There are risks of using a nipple shield, such as decreased milk supply and increased risk of plugged ducts and mastitis. Nipple shields must be sized appropriately for best fit and milk transfer. Your baby’s weight gain should be checked often because often babies do not transfer milk well through a nipple shield.

How to use a nipple shield

• Wash your hands, then apply the clean shield by turning it almost inside out and then roll it back onto the breast over the nipple and areola. Moistening the edges of the nipple shield with water may help the shield cling to your breast.
• Hand express breast milk into the nipple shield or try dripping some expressed breast milk onto the outside of the nipple shield.
• Your baby should be latched deep onto the breast, not just onto the tip of the shield.
• Your baby’s top and bottom lips should be flanged outward (like “fish lips”).
• Your baby should be actively sucking. You should be able to hear and see your baby swallowing frequently. Massage your breast during feeding to help drain the breast.
• You should feel a comfortable tug, and your nipple should look round after the feeding. There should be breast milk in the shield when baby pulls off.

Cleaning the nipple shield

• Wash the shield with hot soapy water and rinse well after each use. Follow package directions if you need to sanitize your shield by boiling. Keep your nipple shield very clean to help reduce the risk of breast infection.

Weaning your baby from the nipple shield

• When you and your baby are ready to stop using a shield, place baby skin to skin with you and start feeding with the nipple shield on. Remove the shield when you hear your baby swallowing at the breast. Then allow your baby to latch without the shield.
• Try starting feedings without the nipple shield.
• Some mothers find their baby will latch without the shield when their baby is sleepy or between feedings.
• Never cut the nipple shield to make it smaller.

When using a nipple shield remember

• Have your baby’s weight checked often by your baby’s healthcare provider or lactation consultant to be sure baby is gaining weight appropriately.
• You will need to use an electric breast pump after feeding to help establish and protect your milk supply, until your baby is transferring milk well at every feeding.
• Talk to a lactation consultant or your healthcare provider if you have concerns about your milk production or baby’s latch when using the shield.

Works Cited

Wambach, Karen and Spencer, Becky “Breastfeeding and Human Lactation”, Sixth edition, Jones & Bartlett, 2021.