Breastfeeding works best and most easily when no gadgets are used. But sometimes a gadget is a tool that can help gadget-free breastfeeding develop. A nipple shield is one such tool.
The nipple shield looks like a clear Mexican hat. The “tip” is the hat’s crown. The “rim” is the hat’s brim. To use a nipple shield most effectively, turn it almost completely inside out, so that the tip is still in the “right” position, but the sides are folded up around it. This makes the tip shorter, bringing it closer to your own nipple tip. You may want to moisten the underside of the rim (the side that goes against the breast). Center the tip over your nipple, then smooth the rim against your breast. Gently tug or bend the tip, and it will pop back into its normal shape, drawing some of your nipple into the tip. Your baby’s sucking will finish drawing your nipple out.
Position your baby so he has to tip his head back and reach for the “nipple”. When he opens WIDE, draw him in close. It’s easy for him to nibble onto the shield. That doesn’t work with a real nipple, so try not to let him do it with the shield. Instead, when his mouth is OPEN, snuggle his shoulders close to you, so that when his mouth closes, his gums close beyond where the tip joins the rim. This is a big mouthful, but a baby normally fills his mouth with at least this much breast tissue. He can do it. If he gags, that may be part of the reason he’s had some trouble with breastfeeding. Keep encouraging him to take a big, big mouthful. It may help to use the smaller “premie” size nipple shield, if that’s comfortable for you.
If he takes a good, big mouthful, he should be able to milk your breast about as well as without the shield. Premies, who can have trouble maintaining a big mouthful of breast, may actually take more milk with a shield than without it. If your baby swallows after every one or two sucks, your breast softens, and your baby lets go and is too full to take any more for 10 minutes or so (most babies love to come back for seconds after a few minutes’ rest), you probably won’t have to pump. But stay in touch with a breastfeeding specialist while you’re using the shield. Some of the time its use causes milk supply problems. A few weight checks will help you know how well it’s working.
If your baby must suck 3 or more times for every swallow, and wants to nurse almost constantly, perhaps with his eyes closed, milk isn’t transferring well. Recheck your baby’s placement, pump after nursing, offer the extra milk to your baby, and stay in touch with a breastfeeding specialist. The pumping will help keep your supply strong and your baby well-fed while you and your baby work through the problem.
If the shield curls over your baby’s nose while he’s nursing, but he stays well-positioned, don’t worry about it. A curling shield usually doesn’t bother the baby.
Remember, babies breastfeed; they don’t nipplefeed. If the shield makes your baby suck only your nipple, something needs to change. But if the shield and baby are well-positioned and your baby swallows well with it, it may be the gadget that helps you get rid of the gadgets.