Your Complete Guide To Nipple Shields

Are you curious about what a nipple shield is and how it fits into breastfeeding? Have you heard you should NEVER use a nipple shield? Are you currently using a nipple shield and wondering how to wean off it successfully? Read on. Let’s demystify nipple shields, and go over why they CAN fit in with some breastfeeding journeys, and why you should not feel bad about using them! 

What are nipple shields?

Nipple shields are small silicone shields that cover the nipple. They can be used to protect a nipple that is sore or damaged from a shallow latch. Nipple shields can also help a baby to latch to a flat or inverted nipple. Infants who are born prematurely and/or have oral dysfunction may also benefit from using a nipple shield to assist with latching to the breast.

When would you use a nipple shield?

Ideally, a nipple shield would be used as a tool in conjunction with the support and education from a lactation consultant. Nipple shields should never be used in place of good latching mechanics and positioning. Make sure you are doing all the latching basics correctly and if you are still struggling a shield may be a helpful tool. Click here for our blog on latching, here. Boob School also contains several modules on latching and a recording of my live class Latched AF Click for more information. 

How to use a nipple shield?

When using a nipple shield proper placement is key. The nipple shield will need to be inverted and suctioned onto the nipple so that the baby is able to latch deeply and effectively transfer milk. Check out this quick reel that shows the proper placement of the nipple shield.

How long can I use a nipple shield?

There is no exact time frame for how long you will need a nipple shield. The goal should always be finding the root cause of WHY you need one and addressing it. For instance, if you need a nipple shield because your baby has a tongue tie, working with an IBCLC on how to optimize oral function and, a possible, tongue tie release would be better than continuing to use the nipple shield with a sub-optimal latch. I recommend when using a nipple shield that you work with an experienced IBCLC that can help you uncover what is going on for you and for your baby that requires the use of the nipple shield to begin with and start developing an exit plan. Click here for a list of tongue-tie-informed providers. If you don't address what set the stage for you to need one, it is hard to wean from the nipple shield.

What type of nipple shield is best?

My favorite nipple shield that I recommend over and over is the Mamivac Cherry-Shaped Nipple Shield. I find this shape adheres well to the nipple and allows the baby to get a deep latch and not just be latched to the nipple shield alone.

Check out this guide on Mamivac sizing.

Another popular choice is the Medela shield, which is conical shaped and what most hospitals give to mothers.  I am not a huge fan of this shape as I find many babies end up slurping the nipple shield into their mouth as opposed to latching. 

There are other shields on the market like the Haakaa brand shield which is shaped like a bottle nipple. These are my least favorite because the baby is not able to get much of the areola pulled into their mouths. Due to the shape of this shield, most mothers will not get effective milk removal. However, these can be helpful in certain scenarios when the baby has a baby breast aversion and prefers bottles. 

Does the size of the nipple shield matter?

YES! Similar to pump flanges, fitting matters with nipple shields. Having the correct size shield helps the baby to get a better latch as opposed to just sucking on the nipple shield itself.  Having the correct nipple shield size also helps by being closer in size to your actual nipple and therefore will be easier to wean from when the time comes. I most often see mothers being given 24mm nipple shields at the hospital and in my experience, this is way too large for the majority of nipples.  

How to measure for a nipple shield?

• Measure the diameter of the nipple with a printable ruler  - make sure you are measuring the actual nipple itself and not the areola 
• Add 2 mm onto the size for a recommended nipple shield size

Are there risks of Nipple Shield use?

• A poorly fitting or poorly applied nipple shield can reduce milk transfer 
• A nipple shield can mask a bigger problem like a tongue tie or oral dysfunction 

Nipple Shield Takeaways

• make sure you are sized correctly
• applying the shield correctly
• work with an IBCLC to get to the root of the problem

My nipple shield experience

Tools exist because sometimes we need help and that is okay!! A nipple shield is a tool I myself used BOTH times I breastfed my babies. That little silicone tool allowed me to breastfeed in the early days and, ultimately, set my course for becoming the IBCLC I am today.  I can honestly say that if I wasn’t able to use a nipple shield, I don’t think I would have been able to breastfeed my kids. I am so grateful that this tool exists for breastfeeding families!

Want to know what using a nipple shield DOES NOT say about you?

It does not mean you didn't try hard enough, that you mustn't be latching correctly, that you will never be able to nurse without one, that your baby is "lazy" or that your baby can't latch. Remember a nipple shield is ONLY a tool and doesn't hold any moral value. If you need help weaning from a nipple shield read on for my top tips for weaning off of one. 

How to Wean from a nipple shield?

Let's fast forward a bit....You have worked with a kickass IBCLC. You have addressed both your and your baby's factors and you are now feeling confident about beginning the weaning process off the nipple shield. Here are my tips to help you navigate the process. 

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How long will it take to wean from the nipple shield?

Weaning from the nipple shield is a process and will have its' ups and down. It can feel like two steps forward and three steps back in the beginning. As a reminder, both you and your baby are on the journey together and both of you will have more and less tolerance for it on certain days/nursing sessions and that is okay. You are learning and so is your baby. Gradual progress over perfection is the goal. There is no right/wrong way to go about weaning the nipple shield and different techniques may work on different days. Remember, using or not using a nipple shield says NOTHING about you or your breastfeeding journey.

Setting the stage for success

Let's avoid a hangry baby: it is not easy for you or your baby to learn a new skill when they are overly hungry. It is best to attempt a nursing session without a shield with a happy and content baby showing early hunger cues. If the baby is already going 0-60, it may be best to use the shield for this session and plan for the next.

Four go-to tips

1. Get those nips ready: you can do a quick pumping session, use a nipple everter tool or pull the nipple out for the baby so that it is more everted and firm.
2. Pinch and pull: while this sounds rather unpleasant, it doesn't have to be and should not hurt! The goal is to punch some of your areola and pull the tissue into your baby's mouth. You may have heard this called the tea-cup hold as well.
3. Baby in the driver's seat: let your baby lead the latch...get skin-to-skin in a deeply reclined position and allow the baby to attempt exploring and self-latching. **This is great when both you and baby are feeling calm and relaxed and the session doesn't need to be rushed. It can also be great to incorporate this into a bathtime where you both are calm, skin-to-skin, and feeling the oxytocin! Click here for our blog on my top tips for a deep latch. For more support with latching, check out Boob School for modules on latching, our bonus latching checklist and access to my best-selling live class Latched AF. 
4. the ole' bait and switch: start your nursing session with the nipple shield, once the baby has a few good sucks under their belt, quickly unlatch, remove the shield, and attempt to latch again. This takes practice and our goal is to keep your baby calm and happy at the breast. The first few or more tries at this may be a resounding, "hell, no!" for your baby. It is okay to put the nipple shield back on and try again later in the day!
   

You did it, you latched your babe without a shield!!! 

This is a huge win and another step in your journey. Keep at it and remember that the journey is more of a winding upward trend than a straight line forward.

Ready for more? I have sooooo much more to share with you in Boob School. Let's unpack breastfeeding together so you can more confidently navigate your way through whatever your feeding journey has in store for you and your babe. With 12+ modules, 11 bonus pdf guides, a membership to Natural Breastfeeding, a private Facebook group for your 2 am questions, and weekly live support calls, you will have the know-how and empowerment to make the choices that are best for YOU and your baby. 

I want you to feel SUPPORTED now and throughout your entire story! It is the support and knowledge I wish I would have had and the breastfeeding class and support network I would want for my baby sister. It is my mission to give parents the support they deserve. See you there!

Cheering you on, always!

XOXO

Kelly

Boob School Founder and CEO

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