Some things in the world - like American football, or Greenland - have names that seem designed to hide what they really are, but others are exactly what they sound like - ice cream, for example, or flying squirrels, or nipple shields. If you're breastfeeding, you may have come across them already, since many nipple shield users are introduced to them early in the breastfeeding process. Others may not come across (or need) nipple shields until they’ve been breastfeeding for a few weeks, or even months. This is because there are several different reasons why fitting a soft, flexible silicone nipple over your own nipple before offering it to your baby to feed might be the right choice for the two of you.
Reasons to use nipple shields can come from the needs of the baby or the mother, depending on what complication they're facing. For example, breastfeeding mothers with flat or inverted nipples are often recommended to use a nipple shield in order to shape their nipples into a position to better allow their babies to latch on. On the other hand, though, nipple shields may be used to help very small or premature babies latch on to larger breasts. These reasons usually come into play early in the breastfeeding relationship, although the La Leche League, an international non-profit dedicated to helping women breastfeed, does not recommend using nipple shields in the first week of breastfeeding because of concerns about nipple-confusion.
Common reasons to introduce nipple shields later on in the breastfeeding process include nipple soreness, chapping, cracking, and even bleeding. Nipple shields can give these symptoms time to heal. The symptoms that need to heal may be a sign of a problem with your baby's latch. If a few days of nursing lead to nipple chapping or cracking serious enough to require nipple shields, it could be a sign that it's time to consult either your healthcare provider or a lactation consultant, to see if they can help your baby latch more easily and comfortably.
There are a few concerns around using nipple shields, including the worry that a lack of nipple stimulation could cause a decrease in milk supply, or the worry that they're inefficient enough to lead to babies getting less milk. These concerns were brought to medical attention at a time when nipple shields were commonly made of thick latex. The thin, silicone version that is commonly used now, was designed to address those concerns. Still, if your baby is not gaining weight at a healthy rate after introducing the nipple shield, it could be a sign that the nipple shield isn’t a good fit for you and her.
Another common concern with nipple shields is that, once they’re introduced, your baby may have a hard time going back to latching on without them. But though there may be a transition period in weaning her away from nipple shields, it’s very rare for babies not to eventually make the switch back.
A popular earlier method for weaning your baby off of using a nipple shield was to snip away a bit more of the shield before every feeding, until your baby was feeding straight from the bare breast again. However, this method was popular in weaning away from the earlier, and currently less common latex version of the nipple shield. The more currently popular design, made of thin silicone, should not be weaned from this way, since cutting the silicone can leave jagged edges that could hurt or irritate both your baby’s mouth and your breast.
Instead, one common weaning method is to begin feeding with the nipple shield, removing it part way through, when your baby is already mid-feed, and then beginning to remove the shield earlier and earlier in feedings until she can do without it. Another method is just to start trying to feed your baby without a nipple shield when she is already sleepy.