7 TIPS FOR WEANING ​FROM A NIPPLE SHIELD

​I typically find it to take clients anywhere between 2 and 4 weeks to wean off a nipple shield from the time they begin working on it. An important first step is identifying why your baby is using a nipple shield to begin with.

​What's the big deal about nipple shields?

 Initially, nothing! They are a tool like anything else to help you meet your breastfeeding goals. Then why is everyone trying to wean off of using them if they aren't so bad?

 They can have a few draw backs, mainly being cumbersome to carry around and put on, in addition to potentially leaving some milk behind in the breast at a feeding if your baby may not be very efficient yet (and they likely are not yet if they are needing to use a shield, but more on that later).

 Frequently a well meaning healthcare provider recommends one to a new parent as a last resort when breastfeeding is not going well in the early days postpartum. They may not know how else to help and feel any suggestion may be better than none, and in comes a shield. Without more information like how to properly put it on, information about sizing, and a functional exam observing the parent and baby actually using the shield it may be a recommendation that still falls short of actually being helpful. They are a wonderful tool to use if you might be in unbearable pain when latching, if you have an injury that is healing, or a baby that will not latch without one.

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 The first example above has no cut out, it is a complete circle. The second is a contact shield, it has a cut away. This is a nice feature that helps to keep a skin-to-skin connection between you and your baby when using a shield. They also tend to fit onto the breast better. The last two are similar to the second, but they have different shapes to their nipples. 
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 A new nipple shield to hit the market a few years ago has a bottle nipple shape on top of it. Though it has in fact been the right tool for the job somewhere, sometime, it is not my first choice if a baby is able to latch onto one of the more standard options. I have personally witnessed it lower some client's supply when not used in conjunction with expression such as pumping after feedings while using it. 
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 So if you've been using a nipple shield now, or you have in the past, you probably know how much trouble they can be to keep track of, keep clean, keep on, and just manage overall. So let's explore some ideas about weaning off of using them.

 It can be quite the dance to drop the nipple shield. There may be several good feedings without the shield in a row, only for baby to regress and want to use the shield again. Over time though these periods of better attachment will become more frequent until they are the new norm. 

​ I typically find it to take clients anywhere between 2 and 4 weeks to wean off a nipple shield from the time they begin working on it. An important first step is identifying why your baby is using a nipple shield to begin with.​

​ Babies generally want to breastfeed, the inability to do so is often just that, that they are unable to. Through further investigation such as an oral exam to assess form and function inside of the mouth, and a latch assessment of feeding at the breast you can uncover and address the root cause of the issue. It may be something as simple as making some improvements in your hands/holding and latching techniques, or it could have more to do with the baby's oral function or anatomy. A skilled International Board Certified Lactation Consultant is a great asset to aid in your investigation and work alongside in your journey. 

 It has been my experience that nipple shield sizing and flange sizing can work a bit differently from each other. If your baby was born prematurely or small for gestational age, you may  need to use the smallest nipple shield possible for your nipple size to accommodate your baby's small mouth diameter. If your baby is born full term and/or over about 8 pounds or more, it is likely that your baby may benefit from using a medium (22 mm - 24 mm) over a small one (16 mm -20 mm) even if your nipple measurement falls within the small range.

 Sizing up your nipple shield when trying to transition to the breast could help your baby learn to open their mouth wider by providing a larger base to latch onto than with a smaller shield with a narrow base. I have frequently observed babies using a small shield to appear to be sucking on a straw, with collapsing cheeks and poor transfer. A larger sized shield may also be an advantage to the tongue tied baby or a baby with a high palate as it may be easier to grab onto something larger if they cannot yet make good contact from tongue to palate.

I have personally found this to be true in my private practice and have seen a great number of successes to getting off of the nipple shield!

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7 TIPS FOR WEANING
​FROM A NIPPLE SHIELD

1. Work with an experienced International Board Certified Lactation Consultant either virtually or in person to evaluate and assess why your baby is using a nipple shield to begin with. Even virtual assessments can prove to be extremely helpful in assessing and evaluating breastfeeding and your baby.
2. Choose a shape and size nipple shield that fits your breast well, your baby can comfortably latch onto, and your baby can transfer milk with.
3. Turn your shield slightly inside out when applying it to your breast and rolling it back onto your areola so that it is not easily knocked off at the beginning of a feeding. It is also helpful to "tack" the top of your shield down using your fingers with the hand on the same side of the body as the breast you are feeding from. Scoop your baby up in a cross cradle position with your opposite hand and bring the baby to your breast pointing the shield to the roof of your baby's mouth.
4. Try taking the shield off during let down and quickly latching your baby back on. If they get upset or cannot, put the shield back on and try again at another feeding.
5. If you are using a cone shaped shield like a Medela, try sizing up your nipple shield to a 21-24mm if you are using a smaller shield and then repeating step 4. If you are using a cherry shaped shield or one like a Lansinoh shape, try sizing as close to your nipple measurement as you can get.
6. Continue pumping to support your supply and/or supplementing if you have been to keep you baby on their growth curve. Through Step 1 - working with an experienced International Board Certified Lactation Consultant, your can assess your baby's transfer of milk at a feeding to ensure their efficiency at the breast is sufficient and they are ready for more changes. 
7. Continue weekly weight checks with your lactation consultant until you feel confident in your milk supply and baby's growth curve.

If you are searching for a virtual lactation consultant to talk you through weaning from your nipple shield I would be honored to assist you!

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