Transcript: The Dos and Don’ts of Nipple Shields
Thre Boob Group
The Dos and Don’ts of Nipple Shields
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
ROBIN KAPLAN: When breastfeeding moms are having difficulties latching or trying to heal some wounded nipples, nipple shields can seem like a gift set from the heaven above. Yet, these little silicone wonders can often pose their own challenges. What are the advantages and disadvantages of using a nipple shield?
Today, I’m thrilled to welcome back to the show, Kristina Chamberlain. Kristina is a certified nurse-midwife an International Board Certified Lactation Consultant in the state of Washington and owner of East Side Women’s Health and Lactation. Today, we’re talking about The Do’s and Don’ts of Nipple Shields. This is The Boob Group Episode 89.
[Theme Music/Intro]
ROBIN KAPLAN: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.
Thanks to all of our loyal listeners who have joined The Boob Group Club. Our members get all of our archived episodes, bonus content for each new show plus special giveaways and discounts. Subscribe to our monthly newsletter for a chance to win a membership to our club each month. Another way for you to stay connected is by downloading our free app available in the Android and iTunes Market Place.
So, we are joined by three lovely panelists in the studio. So, ladies will you please introduce yourselves. Let’s start with you Alicia.
ALICIA BRAVO: Hi. My name is Alicia Bravo and I’m 37 years old. I’m the founder of The Intuitive Mother Circle. I have two beautiful children. I have Tallulah, she is three years old and my son Joaquin just turned one.
ROBIN KAPLAN: All right, thank you.
RACHEL KELTY: I am Rachel Kelty. I am 28. I am a stay-at-home mom to Jane and she is 10 months old.
ROBIN KAPLAN: All right.
KATIE JACQUET REED: I am Katie Jacquet and I’m 31 and I’m a stay-at-home mom and also work part time at a Domestic Violence Shelter. I have two kids. My son Logan is two and a half and my daughter Arwen is eight months.
ROBIN KAPLAN: All right and I also like to give a little shout out to MJ who is in as our producer but also in charge of our Virtual Panellists Program. So, MJ will you tell us a little bit about that?
MJ FISHER: Yeah, Robin our Virtual Panellists Program is a really great way to join our online conversation when we record. If you’re not local or you just can’t be a panelist in the studio and you still want to share your story and your opinion on the topics then you can. We will post on our social media – Facebook and Twitter the same questions that we ask our in studio panelists while we’re recording the show live.
If you want more information, check out are website TheBoobGroup.com under the community tab, you’ll find more info on being a VP and possible perks for participation.
ROBIN KAPLAN: Awesome, all right. Well, thanks MJ.
MJ FISHER: Thank you.
ROBIN KAPLAN: Before we get started with our show, sometimes we’d like to highlight some news headlines that are kind of going around the internet. This one perked my curiosity. It’s out of Connecticut. A mom who was waiting to testify in a case – her name is Danielle. She had a three-month-old son Maddox and she was sitting in Family Court and he needed to be fed, so she started to feed him. The marshal immediately waved her out.
That is what she said was that, “It never happened to me so I wasn’t sure she was speaking to me at first.” So, I kind of looked around and she was like, “You know, you need to get out.” She was actually never able to testify in the case. She said, “She just felt absolutely ashamed” which was terrible because she wanted to feed her child. So, this got a lot of press. Actually, what happened was the marshal was actually in the wrong.
At the state of Connecticut actually protects moms for breastfeeding in public. So, the marshal supervisors apologized and they’re probably going to have some nice little education, some training for their employees there at the courthouse. But, the thing that actually struck me the most was the comments that came after this. You should just never look at comments after articles.
But, the comments really came you know – women should have a place in courtrooms to breastfeed because nursing in the courtroom can be distracting. It’s one of the comments and that she should have left and fed in the ladies room. Then, the one in favor of the mom or some of the ones that favor the mom just said, “Look the law protects her distraction is irrelevant.”
So, I just wanted to kind of throw this out to our panelists, MJ as well as Kristina and just kind of – what is your initial thought when you hear that women are asked to leave when they are breastfeeding in public places? So Katie, what was your initial reaction?
KATIE JACQUET REED: It’s just absurd and sad. There’s nothing more natural than feeding your baby. So, punish this woman and deny of her rights to participate in civil society is wrong. It’s immoral.
ROBIN KAPLAN: It just makes me feel bad too which was just horrible. Rachel, what was your reaction?
RACHEL KELTY: I’m not sure why that marshal – why that was her gut reaction. Why does she think that that’s her place to say that, “That’s not okay.” Why is that the first thing that popped into her head when she saw it like, “I have to stop this.”
ROBIN KAPLAN: Yeah.
RACHEL KELTY: Rather than, “She’s just breastfeeding. Turn around and look away.”
ROBIN KAPLAN: Yeah, absolutely. How about you Alicia?
ALICIA BRAVO: Well, I’m just really surprised. I feel like often when you’re out in public with babies, people like when they hear a baby cry – they would be like, “That baby needs to eat. That baby is hungry.” People have no problem giving their opinions about why; this must be doing for your baby. Then when you actually do what you’re supposed to do for your baby which breastfeeds them, all of a sudden, people will have a problem like, “Why are you doing that?” You will need to do that somewhere else.
But, everyone seems to think that they can tell you what your baby needs but when you give them what they need then all of a sudden
ROBIN KAPLAN: You’re ridiculed.
ALICIA BRAVO: Yeah, so it’s really unfortunate.
ROBIN KAPLAN: MJ, what about you?
MJ FISHER: It’s just so sad to me. I mean I feel for the mom because you know how is she feeling like seeing everybody looked at her? When you’re breastfeeding your child, like for me, “I’m not really looking at everybody around me.” I’m looking at him. I mean it’s a bonding moment not only just nutrition but so just a thought of her feeling like I’m doing something wrong or also the other people that are around. You know, that’s to them saying that, “She’s doing something wrong too.” So, it’s just totally horrible message and
ROBIN KAPLAN: Sending the society.
MJ FISHER: Yeah, exactly. Obviously, it’s something that we need to normalize in the courtroom apparently too.
ROBIN KAPLAN: Well, we have that issue in San Diego too. So, Kristina, did you see this article at all?
KRISTINA CHAMBERLAIN: I didn’t see it. My first thought – I mean agree with what everybody has said by far. But, another thought I had is just the lack of education. People obviously don’t get really what breastfeeding is all about as far as the physiological way of feeding or giving our babies nutrition but we are mammals. We’re just animals and that’s what the sciences as mammals. So, I just feel like it’s a lot of lack of nutrition – education about the nutrition of baby and because of that, we don’t realize what breast are for so we sexualize them and kind of negated its real purpose for them.
Well, as far as the distraction anybody who’s ever tried to give a toddler a snack bag, that’s a [laughing]. But, also, it just really saddens me when I hear that that’s a woman who said that to another woman. I know I shouldn’t be more upset about that but I am. I always feel bummed out when it’s another female telling a female not to breastfeed her baby.
ROBIN KAPLAN: You wanted to say something too Katie?
KATIE JACQUET REED: I just wanted to say, “I’m wondering also of the age of the child that comes into place and so there’s even more stigma with breastfeeding older babies and toddlers.”
ROBIN KAPLAN: Well, this one
KRISTINA CHAMBERLAIN: The baby was actually three months old right?
ROBIN KAPLAN: This one was only three months old.
KATIE JACQUET REED: I’m sorry. I thought you said three years.
ROBIN KAPLAN: That always opens up another can of worms, unfortunately. But, this little one was only three months. I know, you like probably couldn’t even see him. He’s head probably covered the breast and it was totally fine. All right, well thanks, ladies. It’s always nice to banter things and see what’s going on in society when this stuff pops over my Google.
[Theme Music]
Well, today on The Boob Group. We’re discussing The Do’s and Don’ts of Nipple Shields. Our expert Kristina Chamberlain is a certified nurse-midwife, an International Board Certified Lactation Consultant in the State of Washington and owner of East Side Women’s Health and Lactation. Thanks for joining us Kristina and welcome back to the show.
KRISTINA CHAMBERLAIN: Thank you.
ROBIN KAPLAN: So Kristina, what is a nipple shield and how they are used?
KRISTINA CHAMBERLAIN: Well, as we’ve mentioned before Nipple Shield is just a really thin, clear, soft silicone cover. They are made out of silicone which is good for people who have latex allergies because they used it at one point – they made out of latex. But now, all of them are made out of silicone pretty much and its shape is got a little shaft so it’s kind of shaped like a woman’s nipple and it’s just goes right over the nipple. It has holes in it so that milk can transfer from her breast to the nipple shield to baby.
When baby latches on, it’s just as though the baby is breastfeeding. It’s just that there’s this small little cover-up over the nipple.
ROBIN KAPLAN: Okay, why would a mom use a nipple shield?
KRISTINA CHAMBERLAIN: Well, there are a couple of different reasons. Sometimes woman who has flat or inverted nipples, so any nipples that doesn’t really evert or protrude – for some babies, that can be a little bit harder for them to latch on too. They don’t get such a strong stimulation of that nipple rubbing against the roof of their mouth. So, their suck reflex doesn’t kick in as strongly.
So, a nipple shield is hard so it can rub off against the roof of their mouth and kind of tell them that this is something for you to suck on and help with that. The nipple shield can actually help eventually give their nipples to protrude outward and kind of give it that shape. Sometimes babies just have uncoordinated suck. They have any kind of sucking dysfunction or issue. Sometimes the nipple shields like I’ve said before it just creates a stronger stimulation for their suck reflex. So, they kind of just get it faster.
They figure it out and so, it kind of helps them as a tool to use to help them get over their learning curve. Sometimes women will use them as their nipples are really damaged, very sore or cracked and bleeding. It has a barrier over the nipple; she might use that for a short period of time just to help allow her own tissue to heal while she’s still nursing.
ROBIN KAPLAN: Which is nice because then you can – baby still transferring milk from the breast. So, it’s a nice little tool for that.
KRISTINA CHAMBERLAIN: Sometimes they can make it worst if babies just really doesn’t have a good latch or mom hasn’t figured out how to properly use the nipple shield then it can actually make it worst. So, the one thing that I would say first and foremost is, “Anytime that somebody needs to use a nipple shield, they should be working with a lactation consultant.”
One, to make sure things are improving, milk supply and baby’s weight gain aren’t affected but also too, to figure out how to get rid of it eventually.
ROBIN KAPLAN: Yeah, absolutely. Ladies, when were you first given nipple shields and why was it recommended for you? Alicia?
ALICIA BRAVO: My first daughter, my daughter was just three. When she was born, we were in the hospital – she just had a hard time latching. She wasn’t getting milk and it was recommended to use a nipple shield to help give an extension so she could latch on. So, that’s why we started to use it. It was great as far as helping her be able to latch and get milk.
ROBIN KAPLAN: How about you Rachel?
RACHEL KELTY: I went and got one myself after being told that it may be an option. It was about a week after my daughter was born. She had pretty much destroyed my nipples in that first week. So, it was a great relief and the lactation consultant that I was seeing at the time was really helpful in teaching me how to use it when I brought it to the next Boob Group.
ROBIN KAPLAN: How about you Katie?
KATIE JACQUET REED: I was told by a lactation consultant in the hospital that my nipples were short and/or flat. So, that’s why they recommended using a nipple shield. My son could not latch at all neither my daughter without it. So, we got on pretty quickly. In reality, both had tongue-ties. So, we’ll talk more about that later I’m sure but it definitely. I have actually never breastfed at the breast without a shield.
ROBIN KAPLAN: Okay and for me, I definitely used them with both of my boys because like Rachel had mentioned – it wasn’t looking too pretty down there after a couple of days. So, the lactation consultant that came to our home had recommended just so that way will allow my nipples to heal but still be able to feed my kiddo.
So, Kristina is there a right and/or a wrong way to use the nipple shield?
KRISTINA CHAMBERLAIN: Well, nipple shield do come in different sizes as your nipples. So, that would be the first thing is you want to make sure that you get a nipple shield that’s appropriate size. If it’s too small for example that it really isn’t going to transfer as much milk because babies are able to stimulate or compress milk that’s as well. It could also cause more pain to the mom.
If it’s too big, so the nipples to again it creates problems. It might rub or break the nipple into some way and also it’s just might be harder for babies to latch on too if it’s too big for the baby’s mouth. You want to make sure that it really is over the nipple itself. Sometimes baby’s kind of slide around if they’re not put on properly. So, making it sure that it’s in the proper place so that baby is actually compressing as much as the milk that’s as possible.
Just like if you were to latch without a nipple shield, you want your baby to actually be on your breast, you probably all know when or have had hickeys or something like that on our nipple on the baby is on the wrong side. It’s the same thing with the nipple shield; you want to make sure it’s actually off over the nipple.
ROBIN KAPLAN: When are nipples shields most helpful?
KRISTINA CHAMBERLAIN: Well, I find a lot of times – I think of the nipple shield as I’ve said before just as a tool to kind of get over this hurdle. The goal would be for people not to have to use them the whole time they’re breastfeeding. So, I find that they are really helpful for people who have nipples or either soft or flat, don’t evert very easily. If the baby just needs some extra help, I find that to be a really good use of a nipple shield.
I see it sometimes people will give either a lactation consultant or postpartum nurses give nipple shields out very quickly just because baby is not latching well. I think people get really nervous if that’s not happening. I think that’s actually not a good reason to give the nipple shield because it could kind of hide the cause of why the breastfeeding issue and we kind of say, “Well, the baby just needs the nipple shield.” We really not investigate it like one of your panellist said – your baby ended up being tongue-tied.
My oldest daughter – I needed a nipple shield. She didn’t have a strong suck and she was born right at 37 weeks so she was kind of just near term acting baby. Then, she ended up being tongue-tied too. But, I think that everybody just kind of said, “She’s weak because she is 37 weeks and not really looked at her tongue as closely.” So, it’s kind of dismisses other causes that you can think – she just needs a nipple shield. So, that’s another reason I wouldn’t want somebody have to use it for too long. You need to figure out why is this still an issue.
ROBIN KAPLAN: Sure. Ladies, it sounds like you all found the nipple shield to be fairly helpful. So, what is the most helpful in your situation? Alicia?
ALICIA BRAVO: I think for me, it just brought a piece of mind because breastfeeding was really important to me so it just gave me the opportunity to look forward on the breastfeeding. So, I think it just provided that kind of relief for me especially being a new mom.
ROBIN KAPLAN: Sure, absolutely. How about you Rachel?
RACHEL KELTY: It definitely saved our breastfeeding journey and our relationship and it helped – it gave my nipples time to heal so that we could figure out what the problem was which did end up being a tongue-tied. After I had a first her, the midwife was very apprehensive. She didn’t want anybody to talk about nipple shields.
The nurse had mentioned it and she was like, “No, that’s not necessary.” But she didn’t say, “Let’s check first something else.” So, it was kind of like, “You should use it but you shouldn’t use it. But you need it.” So, it’s definitely confusing. But, it was really helpful in helping us continue.
ROBIN KAPLAN: Cool. How about you Katie?
KATIE JACQUET REED: I have a really love-hate relationship with nipple shields. With my son as my first, I definitely hated it because I felt like it was a symbol of everything going wrong and that there was something wrong with my breast or at times, I would wonder, “What’s wrong with him, why isn’t this working?” It was just so unnatural. You know, I never imagined breastfeeding could be like that. It didn’t even occur to me that there were problems that were occurred in breastfeeding.
So, nursing in public too was extremely difficult because I’m not just there yet as far as being able to go without a covering. Let me tell you, “Trying to get the baby on the nipple shield without a cover is almost impossible.” So with my son, I hated it. You know, I tried multiple times to get him off but now. But now with my daughter, that was the only way she could get on. I really embraced it because that’s the only way possible we were going to breastfeed.
It was just a matter of accepting that breastfeeding is going to look differently for me and my family. That just took some time to come to terms and grieve the loss of the “real breastfeeding relationship or natural” I don’t know what people used to described it.
ROBIN KAPLAN: You bring up a really, really good point just kind of that mental shift as well because it’s still allows you to breastfeed her which is really the end goal. It just looks a little different. So, I’m glad that you brought that up. MJ, you have someone online on Facebook who would like to add to the conversation?
MJ FISHER: Yes. Coleena Carollers, I hope I’m saying it right. She says, “I don’t think I would still be nursing if I hadn’t had it.” My son was born with a tongue and lip tie and while it was corrected before we went home, his latch was terrible. I had three and a half days home before I could see a lactation consultant and by day three, I couldn’t bear to let him latch on due to the pain.
I did my best to pump for him that day and felt so defeated in that first visit to my lactation consultant. She introduced me to the nipple shield, got us all set up and like magic, “He was nursing and I wasn’t in an excruciating pain.” It was honestly the greatest gift for us. She says, “PS, little one is now seven months and going strong in our nursing relationship.”
ROBIN KAPLAN: Awesome, very cool. Kristina, just a few more questions before we go to our break – so, you had mentioned that your daughter was 37 weeks and I know when I’m working with moms who have babies that are born before 37 weeks. Sometimes their suck is not as strong even if there isn’t a tongue-tie. Although, there are some 35 weekers I’ve seen who miraculous.
But, sometimes you know, it can be very helpful to have a shield. So, is there a time when baby is developmentally ready to breastfeed without a shield when they’re born prematurely?
KRISTINA CHAMBERLAIN: Well, I think like you’ve mentioned – you just need, have to look at the baby and see where they are. If there’s suck is good and they’re transferring milk then what’s all the proof you need. But, I would say that oftentimes it can be when their adjusted age is termed when it gotten to that point because that’s when physiologically, they’re going to have the muscle strength and the developmental advances to be able to have that suck reflex be as strong as it needs to be. But, yeah if the baby is proving us all wrong then that’s even better.
ROBIN KAPLAN: Yeah, I know right. Don’t you love that? Miranda had posted this question on our Facebook page. For moms who are given a nipple shield for inverted or flat nipples, what are some other options instead of using the shield?
KRISTINA CHAMBERLAIN: Well, there’s this technique called The Hoffman Technique where you actually because what’s happening is when somebody has a flat or an inverted nipple they are at adhesions where the nipple in development, those adhesions didn’t breakup to allow that nipple to shapely protrude. It’s still kind of stuck against the breast itself. So, The Hoffman technique is where you actually separating the breaking down those adhesions. I’m sure anybody could Google how to do that.
So, basically you’re kind of spreading the nipple itself from the areola to break down those adhesions. That’s one thing you could do. There is a tool called the “supple cup” which is kind of like a nipple shield but it’s kind of the shaft does it. It’s a little section cup that goes to the edge of the nipple itself and kind of keep sit in that suctions, protruding, stance the whole time to do the same thing.
Somebody could try pumping right before breastfeeding and that would help to evert or elongate the nipple somewhat so the baby could get a better grasp on to it like a latch. Basically, it’s whatever’s going to help that tissue elongate and stretch out a little bit more.
ROBIN KAPLAN: All right, when we come back – we will discuss with Kristina the disadvantages of using a nipple shield and tips for weaning from it. We’ll be right back. Well, welcome back to the show, we are here with Kristina Chamberlain, an International Board Certified Lactation Consultant in the State of Washington and we are talking about The Do’s and Don’ts of Nipple Shields.
[Theme Music]
ROBIN KAPLAN: So in our first half of this episode, we’ve talked about all of the benefits of using a nipple shield and how it was really, really helpful for myself as well as the moms in the studio. But clearly, there are some disadvantages as well. So, Kristina, what are some of the disadvantages of using a nipple shields?
KRISTINA CHAMBERLAIN: You know again, this is a latch issue with the baby. Sometimes that it looks like the baby is latched on because of its miraculous nipple shield put really they’re pretty much on the shaft part of the nipple shield and they’re not latched on deep enough to where they actually compressing the milk behind the nipple around the areola. So, that has two issues.
One, it means that the nipple shield is preventing the breast from being properly stimulated and it’s decreasing probably the amount of milk transfer the baby is getting. Some studies have shown that it can inhibit to the Oxytocin levels – which is the hormone that causes the let down which might be another reason why some baby too are using a nipple shield aren’t able to transfer as much milk.
Maybe it’s not because of their latch so much but it’s because of this Oxytocin inhibition. So if you are using a nipple shield, it is really important to work with a lactation consultant to have your milk supply asses but also have the baby weighed every few days to make sure that that’s not becoming a problem. You want to deal with it before it becomes a really big problem.
ROBIN KAPLAN: Okay and so, obviously this is kind of leaning towards – it would be helpful to get off the shield as soon as possible or figure out what is actually the reason that it was being used. But, sometimes moms find that they can’t even wean from the nipple shield. So, what precaution should she take? Does she needs to have precautions to keep up her milk supply or is it something like just kind of as couple of days weighing that, that can actually just check and make sure everything’s okay.
KRISTINA CHAMBERLAIN: If she feels like she’s not able – the baby is not able to empty her breast, it’s important that she do that with the pump. That’s another thing your body needs to get to know to make enough milk. So, if your breasts are not emptied adequately they’re not going to refill so to speak. So, most women who end up using a nipple shield probably are pumping more than women who are not using a nipple shield for that reason. So, pumping afterwards to empty the breast can give that the breast extra stimulation would be something I would recommend for most people.
Certainly, there are some herbs that she could take that could help with her supply just if she felt like she needed that. I don’t usually recommend herbs prophylactically unless I have seen an issue. I think pumping more effective if that’s – if you wanted to do something prophylactically to prevent milk decrease and I would use pumping.
ROBIN KAPLAN: Okay. Ladies, was it difficult for you to get off the shield? If so, how long did it take? Were you ever able to get off? I know Katie had mentioned – is your daughter still using it at this point?
KATIE JACQUET REED: My daughter after her second Frenectomy, refuse to go to breast at all. So, right now – I’m exclusively pumping for her. My son nursed the shield until eight months. As I’ve said earlier, I tried multiple times to get him off and it was just a battle. I learned with my daughter not to repeat that mistake and keep the breast a happy place. But, he’s tongue wasn’t correctly revised until he was eight months old.
We’ve seen seven different lactation consultants before it was correctly identified before a dentist could correctly fix it. By then, that’s eight months of learning how to nurse with a nipple shield. That would take an incredible amount of time to kind of retrain him because it’s just different on the nipple shield. He would have none of it. Then of course, he weaned a month later so it’s like after all of that.
With my daughter, what we’re trying to do is get occupational therapy so she can learn how to use her tongue now that she has free range of motion. I think that’s something that all moms who have tongue-tied babies should consider when they get a Frenectomy and they’re trying to get the baby off the nipple shield. They have to learn how to use their tongue properly.
ROBIN KAPLAN: Yeah, absolutely. Rachel, did it take a long time to get off the shield for you?
RACHEL KELTY: It took about three months. I will admit that it may have been longer because I was scared.
ROBIN KAPLAN: Sure.
RACHEL KELTY: It took a little lot of time especially in the middle of the night. It was just so much easier to throw on a shield. I knew that she could latch properly and eat – and we could all be back to sleep quickly. So, that was the main thing of me just being really diligent in making her practice without it.
Once her tongue was clipped and we, you know worked on her latch a lot with the lactation consultant and her through her growth, I feel stretched as well once she got older. So when she was able to latch, it was really just about me taking it off once. My letdown came or just not using it and letting her practice and learn how to latch properly without it.
ROBIN KAPLAN: How about you Alicia?
ALICIA BRAVO: With my daughter, I think she was about six weeks old and every day – I would every time I try to breastfeed her. I would always try without the shield just to keep trying to see if she would latch on and she would get really angry. So, I kept using the shield and then around when she was six weeks, I had a good friend come to visit her who specializes in Endo Massage and Craniosacral work.
So, she was teaching me some things on my daughter. My daughter Tallulah had a knot in her neck. So, she was showing me how to massage it out and then at that time, it was time for me to feed her and I went to put the nipple shield on and my daughter latched before I could even get the shield on. So, it was a simple adjustment for her and her neck that helped her latch on.
My sister-in-law who has a two-month old had a similar issue where her daughter was latching fine on one side but wasn’t latching very well on the other. I was using a nipple shield and then she went to our chiropractor and had an adjustment and she latched beautifully after that. So, I always encourage to take your babies to be evaluated.
ROBIN KAPLAN: It’s a body work – kind of like eating and suck amount as well because that’s huge.
ALICIA BRAVO: I was very fortunate that it was a very short experience with the nipple shield.
ROBIN KAPLAN: Yeah, definitely. MJ, we have a virtual panellist who wants to share some information?
MJ FISHER: Amy Renalo, she says, “I was using one for about a month and then accidentally left it at my parent’s house. Baby girl latch right on that day and we never looked back.” She said, “I locked out.”
ROBIN KAPLAN: I see a lot of my clients whose baby’s are on it for a while and then it’s right around that three month point where I was sudden the baby’s just like, “I don’t need it any more” and they get on. So, sometimes if it’s been a little bit of a battle up until then sometimes they will actually just the latch one just kind of like you were mentioning Alicia in just and never looked back.
ALICIA BRAVO: Yeah, I think that’s the biggest advice my lactation consultant had given me was: “Don’t panic. They usually grow out of it.” So, don’t ever think that it’s like the end of the world even though it feels like that in the moment.
ROBIN KAPLAN: Definitely. Kristina, what tips do you have for weaning off the nipple shield? Some of the moms mentioned, waiting until let down was over and then try to take it off – what are some good recommendations that you have?
KRISTINA CHAMBERLAIN: Yeah, I would say that’s a good one I hear a mom says is, “It’s most successful for them as where the baby starts with the nipple shield.” I call it “the bait and switch.” Take the nipple shield off and then they just don’t realize it or don’t care that you’ve taken it off like you can continue nursing. Sometimes, if you weren’t to not try the nipple shield at all and just go right through the breast, you can have baby stuck on your finger for a little bit just to help organize their suck.
Your finger is hard like the nipple shields so that might help them get that really strong message for their suck reflex. Once their suck is organized and they gotten that message – it might be easier for them to just latch on to the breast without the nipple shield. I have a lot of clients who tell me that they find it’s easier at night to not use the nipple shield than it is during the daytime.
I don’t know if you’ve heard that from your clients but I hear that all the time. I don’t know if it’s because everybody is a little calmer or more relaxed and if it’s their quiet time or there’s less stimulation or what. Our baby is if there’s still a little sleepy, they’re not going to protest not having the nipple shield as much. But, that’s one thing I hear over and over again that moms are even more successful at night than they are during the day when they’re trying to at first wean.
ROBIN KAPLAN: Sure.
KRISTINA CHAMBERLAIN: So, moms could also try to stay like they needed to still pump a little bit just to get their nipples to evert and kind of being more elongated for babies. That’s another thing you could do, just pump for a minute or two before you’d actually latch the baby on even with a manual pump.
ROBIN KAPLAN: Okay, even something that Katie had mentioned was she wanted to keep the breast the happy place. So, I hear a lot of moms ask, “What if my baby discontinues to cry at the bare nipple and cannot latch without the shield – should mom keep trying without the shield or should she instead kind of favour this that’s actually help our baby get on?”
KRISTINA CHAMBERLAIN: No, I mean I definitely would go for breastfeeding with the nipple shield over not breastfeeding at all or not having you know, a fun time with breastfeeding. So, for moms who find that their baby is really very frustrated and not happy with the breast, I definitely would say, “You give it a good old try and really try and get your baby to breastfeed unless you kind of figure it out for you know usually up to 15 minutes but at that point, I wouldn’t push it longer than that.”
I would recommend doing a lot of skin-to-skin with that baby as much as possible and just keeping baby always kind of near your naked chest. Sometimes babies just start off by looking in the nipple. Or just, they can smell the milk – they snuggle sometimes taking bath with them while they’re just next to the breast and kind of copes with them into – on their terms. They’re coming to the breast when it’s comfortable for them. Nobody’s pushing them. Sometimes that can also help the transition.
ROBIN KAPLAN: Okay and Jena had posted on our Facebook page. Is it possible to start using the shield during teething to help from getting nicked by the small sharp baby teeth? Often those top ones rather than those bottom ones that are covered by the tongue – is this something you would ever recommend?
KRISTINA CHAMBERLAIN: Well, I guess if the mom was finding that it was a problem over and over again, she could certainly try that again to protect. I wouldn’t think that that’s a – I haven’t had a lot of client myself who have started and continued using it for a long period of time during that. I feel like if your baby is latched on really well and they’re not easily distracted at the breast teething or teeth in out of self shouldn’t necessarily prevent breastfeeding from going well – you should be able to continue.
So, I would say, “She felt like she needed that to protect her nipples because she was getting bitten or something like that but I don’t think it would necessarily need to be use forever.” But then if baby is getting a lot of milk and getting well and has not affecting her supply then that works for them. I think that works for them.
ROBIN KAPLAN: Our panellist Katie had a question for you as well Kristina.
KATIE JACQUET REED: Hi. My question is about specifically pumping in supply with the nipple shield. I seem to be like two schools of thought with my son, I was told repeatedly I needed to pump as long as I was using the nipple shield because over time, it would lower my supply. So, I did and pump seven times a day after each feed for the whole duration. I actually had an abundant over supply and he never lost weight or anything.
I found out in retrospect that I was actually because of my oversupply that he was able to gain in spite of the tongue-tie because it basically would just gush into his mouth and he didn’t have to do much work. I mean with my daughter, I was told by a different set of folks that I did not have to pump because as long as she was removing milk, my supply shouldn’t be affected. Yet, when I did that in about three weeks, we had a crisis point because even though my supply normalized, she could not use her tongue to get it out.
So basically with both of my kids, they needed to have an artificially high supply in order to nurse effectively even with the shield. So, can you clarify like do we pump with the nipple shield or do we not pump?
KRISTINA CHAMBERLAIN: Well, it sounds like in your specific case, the bigger issue is that they are tongue tied in effect that because your daughter wasn’t diagnosed right so for a few weeks?
KATIE JACQUET REED: She was and she was clipped in the NICU but not far enough.
KRISTINA CHAMBERLAIN: So, regardless of your reason – a nipple shield are not or pumping or not, if she is enable to use her tongue, if her tongue function is compromised because of her frenulum then that’s what’s affecting your milk supply. So, if that’s the case and she’s not able to empty your breast then yes, pumping would help.
If she had a totally normal latch and her tongue-tied correction was adequate then you wouldn’t have to worry about it anymore in theory. What I would say is, “If somebody is using a nipple shield, I do recommend that they pump because I suspect baby is not going to be emptying their breast as well – either because reusing a nipple shield because baby doesn’t have a really strong or coordinated suck or the nipple shield is preventing their breast from getting all the stimulation it needs to like get the message.”
So, my recommendation would be to pump – if you’re using a nipple shield but if you’re having your baby weighed, I would recommend having your baby weigh every few days like every three to four days. Then, that includes the pre-impose read if you can do that because not only you’re checking baby’s growth pattern but also just transfer the doing pre-imposed weighed to see what baby is actually transferring at that time and that would kind of tell you to if you need to continue pumping or if you were pumping then you need to start pumping.
I think having really good follow-up can answer a lot of those questions. They don’t feel like, “I’m stuck pumping seven times a day forever.”
KATIE JACQUET REED: Yeah and with my daughter she transferred just fine. So, that’s why everyone was kind of perplexed but it’s only because of my oversupply that she was able to make that happen. So, the paediatrician that was working with us told me, “No, you don’t have to pump because look, she’s transferring enough milk and yet three weeks later once I stop pumping – that’s when she started losing weight.”
KRISTINA CHAMBERLAIN: I mean it’s nice that your supply to compensate but there are tricks everybody. I mean I have seen that happen. So, but if you were stop pumping – helpfully you would still have your baby follow up after that, you were not pumping for such a long period of time that you had to work so hard to get your supply back up.
That’s what I’m saying kind of, “Continue to have follow-up every few days.” Check in baby’s weight even after you stop pumping to make sure that that really is the right plan for you guys.
ROBIN KAPLAN: Thank you. Well thank you so much Kristina and to our panellists for sharing this incredibly valuable information about The Do’s and Don’ts of Nipple Shields. For our Boob Group Club members, our conversation will continue after the end of the show as Kristina will discuss how the nipple shield can be helpful for getting baby back to breast when the baby is only taking a bottle.
For more information about our Boob Group Club, please visit our website at www.TheBoobGroup.com .
AUTUMN BONNER: Hi Boob Group. My name is Autumn Bonner. I’m the co-owner and founder of Tailored Fitness an online video based workout program for moms. I’m here today to give you some tips on exercising after having your baby. Did you know that caring for a newborn can wreak havoc on your posture?
The weight of your breast leaning over while nursing and changing diapers and carrying your baby in cradle hold – all cause your shoulders to hunch forward. This makes your chest muscles tight while the muscles in your middle and upper back grow weak. Luckily, regular exercise can help you get your posture back. Good posture instantly makes you appear slimmer and feel more confident.
To strengthen the muscles in your back, try this exercise. With your arms straight out in front of you spaced about shoulder-width apart, hold your resistance band with both hands. Keeping your arms straight, pull your hands apart stretching the band and bringing your shoulder blades together in the back, keep going until your arms are straight out to your Return slowly to the starting position and repeat for two sets of 10.
Just stretch your chest muscles; open your arms wide to a T Position and hold for 30 seconds. To learn more great exercises created just for new moms, check out our videos at MyTailoredFitness.com and keep tuning in to The Boob Group for more great tips on exercising postpartum.
ROBIN KAPLAN: That wraps up our show for today. We appreciate you listening to The Boob Group. Don’t forget to check out our shows, “Preggie Pals for expecting parents” our show, “Parent Savers for moms and dads with newborns, infants and toddlers” and our brand new show, “Twin Talks, that talks about caring for twins from pregnancy through age five.” Thanks for listening to The Boob Group, your judgment-free breastfeeding resource.”
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
End of Audio
[00:41:10]
Episode Transcript
Thre Boob Group
The Dos and Don’ts of Nipple Shields
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
ROBIN KAPLAN: When breastfeeding moms are having difficulties latching or trying to heal some wounded nipples, nipple shields can seem like a gift set from the heaven above. Yet, these little silicone wonders can often pose their own challenges. What are the advantages and disadvantages of using a nipple shield?
Today, I’m thrilled to welcome back to the show, Kristina Chamberlain. Kristina is a certified nurse-midwife an International Board Certified Lactation Consultant in the state of Washington and owner of East Side Women’s Health and Lactation. Today, we’re talking about The Do’s and Don’ts of Nipple Shields. This is The Boob Group Episode 89.
[Theme Music/Intro]
ROBIN KAPLAN: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.
Thanks to all of our loyal listeners who have joined The Boob Group Club. Our members get all of our archived episodes, bonus content for each new show plus special giveaways and discounts. Subscribe to our monthly newsletter for a chance to win a membership to our club each month. Another way for you to stay connected is by downloading our free app available in the Android and iTunes Market Place.
So, we are joined by three lovely panelists in the studio. So, ladies will you please introduce yourselves. Let’s start with you Alicia.
ALICIA BRAVO: Hi. My name is Alicia Bravo and I’m 37 years old. I’m the founder of The Intuitive Mother Circle. I have two beautiful children. I have Tallulah, she is three years old and my son Joaquin just turned one.
ROBIN KAPLAN: All right, thank you.
RACHEL KELTY: I am Rachel Kelty. I am 28. I am a stay-at-home mom to Jane and she is 10 months old.
ROBIN KAPLAN: All right.
KATIE JACQUET REED: I am Katie Jacquet and I’m 31 and I’m a stay-at-home mom and also work part time at a Domestic Violence Shelter. I have two kids. My son Logan is two and a half and my daughter Arwen is eight months.
ROBIN KAPLAN: All right and I also like to give a little shout out to MJ who is in as our producer but also in charge of our Virtual Panellists Program. So, MJ will you tell us a little bit about that?
MJ FISHER: Yeah, Robin our Virtual Panellists Program is a really great way to join our online conversation when we record. If you’re not local or you just can’t be a panelist in the studio and you still want to share your story and your opinion on the topics then you can. We will post on our social media – Facebook and Twitter the same questions that we ask our in studio panelists while we’re recording the show live.
If you want more information, check out are website TheBoobGroup.com under the community tab, you’ll find more info on being a VP and possible perks for participation.
ROBIN KAPLAN: Awesome, all right. Well, thanks MJ.
MJ FISHER: Thank you.
ROBIN KAPLAN: Before we get started with our show, sometimes we’d like to highlight some news headlines that are kind of going around the internet. This one perked my curiosity. It’s out of Connecticut. A mom who was waiting to testify in a case – her name is Danielle. She had a three-month-old son Maddox and she was sitting in Family Court and he needed to be fed, so she started to feed him. The marshal immediately waved her out.
That is what she said was that, “It never happened to me so I wasn’t sure she was speaking to me at first.” So, I kind of looked around and she was like, “You know, you need to get out.” She was actually never able to testify in the case. She said, “She just felt absolutely ashamed” which was terrible because she wanted to feed her child. So, this got a lot of press. Actually, what happened was the marshal was actually in the wrong.
At the state of Connecticut actually protects moms for breastfeeding in public. So, the marshal supervisors apologized and they’re probably going to have some nice little education, some training for their employees there at the courthouse. But, the thing that actually struck me the most was the comments that came after this. You should just never look at comments after articles.
But, the comments really came you know – women should have a place in courtrooms to breastfeed because nursing in the courtroom can be distracting. It’s one of the comments and that she should have left and fed in the ladies room. Then, the one in favor of the mom or some of the ones that favor the mom just said, “Look the law protects her distraction is irrelevant.”
So, I just wanted to kind of throw this out to our panelists, MJ as well as Kristina and just kind of – what is your initial thought when you hear that women are asked to leave when they are breastfeeding in public places? So Katie, what was your initial reaction?
KATIE JACQUET REED: It’s just absurd and sad. There’s nothing more natural than feeding your baby. So, punish this woman and deny of her rights to participate in civil society is wrong. It’s immoral.
ROBIN KAPLAN: It just makes me feel bad too which was just horrible. Rachel, what was your reaction?
RACHEL KELTY: I’m not sure why that marshal – why that was her gut reaction. Why does she think that that’s her place to say that, “That’s not okay.” Why is that the first thing that popped into her head when she saw it like, “I have to stop this.”
ROBIN KAPLAN: Yeah.
RACHEL KELTY: Rather than, “She’s just breastfeeding. Turn around and look away.”
ROBIN KAPLAN: Yeah, absolutely. How about you Alicia?
ALICIA BRAVO: Well, I’m just really surprised. I feel like often when you’re out in public with babies, people like when they hear a baby cry – they would be like, “That baby needs to eat. That baby is hungry.” People have no problem giving their opinions about why; this must be doing for your baby. Then when you actually do what you’re supposed to do for your baby which breastfeeds them, all of a sudden, people will have a problem like, “Why are you doing that?” You will need to do that somewhere else.
But, everyone seems to think that they can tell you what your baby needs but when you give them what they need then all of a sudden
ROBIN KAPLAN: You’re ridiculed.
ALICIA BRAVO: Yeah, so it’s really unfortunate.
ROBIN KAPLAN: MJ, what about you?
MJ FISHER: It’s just so sad to me. I mean I feel for the mom because you know how is she feeling like seeing everybody looked at her? When you’re breastfeeding your child, like for me, “I’m not really looking at everybody around me.” I’m looking at him. I mean it’s a bonding moment not only just nutrition but so just a thought of her feeling like I’m doing something wrong or also the other people that are around. You know, that’s to them saying that, “She’s doing something wrong too.” So, it’s just totally horrible message and
ROBIN KAPLAN: Sending the society.
MJ FISHER: Yeah, exactly. Obviously, it’s something that we need to normalize in the courtroom apparently too.
ROBIN KAPLAN: Well, we have that issue in San Diego too. So, Kristina, did you see this article at all?
KRISTINA CHAMBERLAIN: I didn’t see it. My first thought – I mean agree with what everybody has said by far. But, another thought I had is just the lack of education. People obviously don’t get really what breastfeeding is all about as far as the physiological way of feeding or giving our babies nutrition but we are mammals. We’re just animals and that’s what the sciences as mammals. So, I just feel like it’s a lot of lack of nutrition – education about the nutrition of baby and because of that, we don’t realize what breast are for so we sexualize them and kind of negated its real purpose for them.
Well, as far as the distraction anybody who’s ever tried to give a toddler a snack bag, that’s a [laughing]. But, also, it just really saddens me when I hear that that’s a woman who said that to another woman. I know I shouldn’t be more upset about that but I am. I always feel bummed out when it’s another female telling a female not to breastfeed her baby.
ROBIN KAPLAN: You wanted to say something too Katie?
KATIE JACQUET REED: I just wanted to say, “I’m wondering also of the age of the child that comes into place and so there’s even more stigma with breastfeeding older babies and toddlers.”
ROBIN KAPLAN: Well, this one
KRISTINA CHAMBERLAIN: The baby was actually three months old right?
ROBIN KAPLAN: This one was only three months old.
KATIE JACQUET REED: I’m sorry. I thought you said three years.
ROBIN KAPLAN: That always opens up another can of worms, unfortunately. But, this little one was only three months. I know, you like probably couldn’t even see him. He’s head probably covered the breast and it was totally fine. All right, well thanks, ladies. It’s always nice to banter things and see what’s going on in society when this stuff pops over my Google.
[Theme Music]
Well, today on The Boob Group. We’re discussing The Do’s and Don’ts of Nipple Shields. Our expert Kristina Chamberlain is a certified nurse-midwife, an International Board Certified Lactation Consultant in the State of Washington and owner of East Side Women’s Health and Lactation. Thanks for joining us Kristina and welcome back to the show.
KRISTINA CHAMBERLAIN: Thank you.
ROBIN KAPLAN: So Kristina, what is a nipple shield and how they are used?
KRISTINA CHAMBERLAIN: Well, as we’ve mentioned before Nipple Shield is just a really thin, clear, soft silicone cover. They are made out of silicone which is good for people who have latex allergies because they used it at one point – they made out of latex. But now, all of them are made out of silicone pretty much and its shape is got a little shaft so it’s kind of shaped like a woman’s nipple and it’s just goes right over the nipple. It has holes in it so that milk can transfer from her breast to the nipple shield to baby.
When baby latches on, it’s just as though the baby is breastfeeding. It’s just that there’s this small little cover-up over the nipple.
ROBIN KAPLAN: Okay, why would a mom use a nipple shield?
KRISTINA CHAMBERLAIN: Well, there are a couple of different reasons. Sometimes woman who has flat or inverted nipples, so any nipples that doesn’t really evert or protrude – for some babies, that can be a little bit harder for them to latch on too. They don’t get such a strong stimulation of that nipple rubbing against the roof of their mouth. So, their suck reflex doesn’t kick in as strongly.
So, a nipple shield is hard so it can rub off against the roof of their mouth and kind of tell them that this is something for you to suck on and help with that. The nipple shield can actually help eventually give their nipples to protrude outward and kind of give it that shape. Sometimes babies just have uncoordinated suck. They have any kind of sucking dysfunction or issue. Sometimes the nipple shields like I’ve said before it just creates a stronger stimulation for their suck reflex. So, they kind of just get it faster.
They figure it out and so, it kind of helps them as a tool to use to help them get over their learning curve. Sometimes women will use them as their nipples are really damaged, very sore or cracked and bleeding. It has a barrier over the nipple; she might use that for a short period of time just to help allow her own tissue to heal while she’s still nursing.
ROBIN KAPLAN: Which is nice because then you can – baby still transferring milk from the breast. So, it’s a nice little tool for that.
KRISTINA CHAMBERLAIN: Sometimes they can make it worst if babies just really doesn’t have a good latch or mom hasn’t figured out how to properly use the nipple shield then it can actually make it worst. So, the one thing that I would say first and foremost is, “Anytime that somebody needs to use a nipple shield, they should be working with a lactation consultant.”
One, to make sure things are improving, milk supply and baby’s weight gain aren’t affected but also too, to figure out how to get rid of it eventually.
ROBIN KAPLAN: Yeah, absolutely. Ladies, when were you first given nipple shields and why was it recommended for you? Alicia?
ALICIA BRAVO: My first daughter, my daughter was just three. When she was born, we were in the hospital – she just had a hard time latching. She wasn’t getting milk and it was recommended to use a nipple shield to help give an extension so she could latch on. So, that’s why we started to use it. It was great as far as helping her be able to latch and get milk.
ROBIN KAPLAN: How about you Rachel?
RACHEL KELTY: I went and got one myself after being told that it may be an option. It was about a week after my daughter was born. She had pretty much destroyed my nipples in that first week. So, it was a great relief and the lactation consultant that I was seeing at the time was really helpful in teaching me how to use it when I brought it to the next Boob Group.
ROBIN KAPLAN: How about you Katie?
KATIE JACQUET REED: I was told by a lactation consultant in the hospital that my nipples were short and/or flat. So, that’s why they recommended using a nipple shield. My son could not latch at all neither my daughter without it. So, we got on pretty quickly. In reality, both had tongue-ties. So, we’ll talk more about that later I’m sure but it definitely. I have actually never breastfed at the breast without a shield.
ROBIN KAPLAN: Okay and for me, I definitely used them with both of my boys because like Rachel had mentioned – it wasn’t looking too pretty down there after a couple of days. So, the lactation consultant that came to our home had recommended just so that way will allow my nipples to heal but still be able to feed my kiddo.
So, Kristina is there a right and/or a wrong way to use the nipple shield?
KRISTINA CHAMBERLAIN: Well, nipple shield do come in different sizes as your nipples. So, that would be the first thing is you want to make sure that you get a nipple shield that’s appropriate size. If it’s too small for example that it really isn’t going to transfer as much milk because babies are able to stimulate or compress milk that’s as well. It could also cause more pain to the mom.
If it’s too big, so the nipples to again it creates problems. It might rub or break the nipple into some way and also it’s just might be harder for babies to latch on too if it’s too big for the baby’s mouth. You want to make sure that it really is over the nipple itself. Sometimes baby’s kind of slide around if they’re not put on properly. So, making it sure that it’s in the proper place so that baby is actually compressing as much as the milk that’s as possible.
Just like if you were to latch without a nipple shield, you want your baby to actually be on your breast, you probably all know when or have had hickeys or something like that on our nipple on the baby is on the wrong side. It’s the same thing with the nipple shield; you want to make sure it’s actually off over the nipple.
ROBIN KAPLAN: When are nipples shields most helpful?
KRISTINA CHAMBERLAIN: Well, I find a lot of times – I think of the nipple shield as I’ve said before just as a tool to kind of get over this hurdle. The goal would be for people not to have to use them the whole time they’re breastfeeding. So, I find that they are really helpful for people who have nipples or either soft or flat, don’t evert very easily. If the baby just needs some extra help, I find that to be a really good use of a nipple shield.
I see it sometimes people will give either a lactation consultant or postpartum nurses give nipple shields out very quickly just because baby is not latching well. I think people get really nervous if that’s not happening. I think that’s actually not a good reason to give the nipple shield because it could kind of hide the cause of why the breastfeeding issue and we kind of say, “Well, the baby just needs the nipple shield.” We really not investigate it like one of your panellist said – your baby ended up being tongue-tied.
My oldest daughter – I needed a nipple shield. She didn’t have a strong suck and she was born right at 37 weeks so she was kind of just near term acting baby. Then, she ended up being tongue-tied too. But, I think that everybody just kind of said, “She’s weak because she is 37 weeks and not really looked at her tongue as closely.” So, it’s kind of dismisses other causes that you can think – she just needs a nipple shield. So, that’s another reason I wouldn’t want somebody have to use it for too long. You need to figure out why is this still an issue.
ROBIN KAPLAN: Sure. Ladies, it sounds like you all found the nipple shield to be fairly helpful. So, what is the most helpful in your situation? Alicia?
ALICIA BRAVO: I think for me, it just brought a piece of mind because breastfeeding was really important to me so it just gave me the opportunity to look forward on the breastfeeding. So, I think it just provided that kind of relief for me especially being a new mom.
ROBIN KAPLAN: Sure, absolutely. How about you Rachel?
RACHEL KELTY: It definitely saved our breastfeeding journey and our relationship and it helped – it gave my nipples time to heal so that we could figure out what the problem was which did end up being a tongue-tied. After I had a first her, the midwife was very apprehensive. She didn’t want anybody to talk about nipple shields.
The nurse had mentioned it and she was like, “No, that’s not necessary.” But she didn’t say, “Let’s check first something else.” So, it was kind of like, “You should use it but you shouldn’t use it. But you need it.” So, it’s definitely confusing. But, it was really helpful in helping us continue.
ROBIN KAPLAN: Cool. How about you Katie?
KATIE JACQUET REED: I have a really love-hate relationship with nipple shields. With my son as my first, I definitely hated it because I felt like it was a symbol of everything going wrong and that there was something wrong with my breast or at times, I would wonder, “What’s wrong with him, why isn’t this working?” It was just so unnatural. You know, I never imagined breastfeeding could be like that. It didn’t even occur to me that there were problems that were occurred in breastfeeding.
So, nursing in public too was extremely difficult because I’m not just there yet as far as being able to go without a covering. Let me tell you, “Trying to get the baby on the nipple shield without a cover is almost impossible.” So with my son, I hated it. You know, I tried multiple times to get him off but now. But now with my daughter, that was the only way she could get on. I really embraced it because that’s the only way possible we were going to breastfeed.
It was just a matter of accepting that breastfeeding is going to look differently for me and my family. That just took some time to come to terms and grieve the loss of the “real breastfeeding relationship or natural” I don’t know what people used to described it.
ROBIN KAPLAN: You bring up a really, really good point just kind of that mental shift as well because it’s still allows you to breastfeed her which is really the end goal. It just looks a little different. So, I’m glad that you brought that up. MJ, you have someone online on Facebook who would like to add to the conversation?
MJ FISHER: Yes. Coleena Carollers, I hope I’m saying it right. She says, “I don’t think I would still be nursing if I hadn’t had it.” My son was born with a tongue and lip tie and while it was corrected before we went home, his latch was terrible. I had three and a half days home before I could see a lactation consultant and by day three, I couldn’t bear to let him latch on due to the pain.
I did my best to pump for him that day and felt so defeated in that first visit to my lactation consultant. She introduced me to the nipple shield, got us all set up and like magic, “He was nursing and I wasn’t in an excruciating pain.” It was honestly the greatest gift for us. She says, “PS, little one is now seven months and going strong in our nursing relationship.”
ROBIN KAPLAN: Awesome, very cool. Kristina, just a few more questions before we go to our break – so, you had mentioned that your daughter was 37 weeks and I know when I’m working with moms who have babies that are born before 37 weeks. Sometimes their suck is not as strong even if there isn’t a tongue-tie. Although, there are some 35 weekers I’ve seen who miraculous.
But, sometimes you know, it can be very helpful to have a shield. So, is there a time when baby is developmentally ready to breastfeed without a shield when they’re born prematurely?
KRISTINA CHAMBERLAIN: Well, I think like you’ve mentioned – you just need, have to look at the baby and see where they are. If there’s suck is good and they’re transferring milk then what’s all the proof you need. But, I would say that oftentimes it can be when their adjusted age is termed when it gotten to that point because that’s when physiologically, they’re going to have the muscle strength and the developmental advances to be able to have that suck reflex be as strong as it needs to be. But, yeah if the baby is proving us all wrong then that’s even better.
ROBIN KAPLAN: Yeah, I know right. Don’t you love that? Miranda had posted this question on our Facebook page. For moms who are given a nipple shield for inverted or flat nipples, what are some other options instead of using the shield?
KRISTINA CHAMBERLAIN: Well, there’s this technique called The Hoffman Technique where you actually because what’s happening is when somebody has a flat or an inverted nipple they are at adhesions where the nipple in development, those adhesions didn’t breakup to allow that nipple to shapely protrude. It’s still kind of stuck against the breast itself. So, The Hoffman technique is where you actually separating the breaking down those adhesions. I’m sure anybody could Google how to do that.
So, basically you’re kind of spreading the nipple itself from the areola to break down those adhesions. That’s one thing you could do. There is a tool called the “supple cup” which is kind of like a nipple shield but it’s kind of the shaft does it. It’s a little section cup that goes to the edge of the nipple itself and kind of keep sit in that suctions, protruding, stance the whole time to do the same thing.
Somebody could try pumping right before breastfeeding and that would help to evert or elongate the nipple somewhat so the baby could get a better grasp on to it like a latch. Basically, it’s whatever’s going to help that tissue elongate and stretch out a little bit more.
ROBIN KAPLAN: All right, when we come back – we will discuss with Kristina the disadvantages of using a nipple shield and tips for weaning from it. We’ll be right back. Well, welcome back to the show, we are here with Kristina Chamberlain, an International Board Certified Lactation Consultant in the State of Washington and we are talking about The Do’s and Don’ts of Nipple Shields.
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ROBIN KAPLAN: So in our first half of this episode, we’ve talked about all of the benefits of using a nipple shield and how it was really, really helpful for myself as well as the moms in the studio. But clearly, there are some disadvantages as well. So, Kristina, what are some of the disadvantages of using a nipple shields?
KRISTINA CHAMBERLAIN: You know again, this is a latch issue with the baby. Sometimes that it looks like the baby is latched on because of its miraculous nipple shield put really they’re pretty much on the shaft part of the nipple shield and they’re not latched on deep enough to where they actually compressing the milk behind the nipple around the areola. So, that has two issues.
One, it means that the nipple shield is preventing the breast from being properly stimulated and it’s decreasing probably the amount of milk transfer the baby is getting. Some studies have shown that it can inhibit to the Oxytocin levels – which is the hormone that causes the let down which might be another reason why some baby too are using a nipple shield aren’t able to transfer as much milk.
Maybe it’s not because of their latch so much but it’s because of this Oxytocin inhibition. So if you are using a nipple shield, it is really important to work with a lactation consultant to have your milk supply asses but also have the baby weighed every few days to make sure that that’s not becoming a problem. You want to deal with it before it becomes a really big problem.
ROBIN KAPLAN: Okay and so, obviously this is kind of leaning towards – it would be helpful to get off the shield as soon as possible or figure out what is actually the reason that it was being used. But, sometimes moms find that they can’t even wean from the nipple shield. So, what precaution should she take? Does she needs to have precautions to keep up her milk supply or is it something like just kind of as couple of days weighing that, that can actually just check and make sure everything’s okay.
KRISTINA CHAMBERLAIN: If she feels like she’s not able – the baby is not able to empty her breast, it’s important that she do that with the pump. That’s another thing your body needs to get to know to make enough milk. So, if your breasts are not emptied adequately they’re not going to refill so to speak. So, most women who end up using a nipple shield probably are pumping more than women who are not using a nipple shield for that reason. So, pumping afterwards to empty the breast can give that the breast extra stimulation would be something I would recommend for most people.
Certainly, there are some herbs that she could take that could help with her supply just if she felt like she needed that. I don’t usually recommend herbs prophylactically unless I have seen an issue. I think pumping more effective if that’s – if you wanted to do something prophylactically to prevent milk decrease and I would use pumping.
ROBIN KAPLAN: Okay. Ladies, was it difficult for you to get off the shield? If so, how long did it take? Were you ever able to get off? I know Katie had mentioned – is your daughter still using it at this point?
KATIE JACQUET REED: My daughter after her second Frenectomy, refuse to go to breast at all. So, right now – I’m exclusively pumping for her. My son nursed the shield until eight months. As I’ve said earlier, I tried multiple times to get him off and it was just a battle. I learned with my daughter not to repeat that mistake and keep the breast a happy place. But, he’s tongue wasn’t correctly revised until he was eight months old.
We’ve seen seven different lactation consultants before it was correctly identified before a dentist could correctly fix it. By then, that’s eight months of learning how to nurse with a nipple shield. That would take an incredible amount of time to kind of retrain him because it’s just different on the nipple shield. He would have none of it. Then of course, he weaned a month later so it’s like after all of that.
With my daughter, what we’re trying to do is get occupational therapy so she can learn how to use her tongue now that she has free range of motion. I think that’s something that all moms who have tongue-tied babies should consider when they get a Frenectomy and they’re trying to get the baby off the nipple shield. They have to learn how to use their tongue properly.
ROBIN KAPLAN: Yeah, absolutely. Rachel, did it take a long time to get off the shield for you?
RACHEL KELTY: It took about three months. I will admit that it may have been longer because I was scared.
ROBIN KAPLAN: Sure.
RACHEL KELTY: It took a little lot of time especially in the middle of the night. It was just so much easier to throw on a shield. I knew that she could latch properly and eat – and we could all be back to sleep quickly. So, that was the main thing of me just being really diligent in making her practice without it.
Once her tongue was clipped and we, you know worked on her latch a lot with the lactation consultant and her through her growth, I feel stretched as well once she got older. So when she was able to latch, it was really just about me taking it off once. My letdown came or just not using it and letting her practice and learn how to latch properly without it.
ROBIN KAPLAN: How about you Alicia?
ALICIA BRAVO: With my daughter, I think she was about six weeks old and every day – I would every time I try to breastfeed her. I would always try without the shield just to keep trying to see if she would latch on and she would get really angry. So, I kept using the shield and then around when she was six weeks, I had a good friend come to visit her who specializes in Endo Massage and Craniosacral work.
So, she was teaching me some things on my daughter. My daughter Tallulah had a knot in her neck. So, she was showing me how to massage it out and then at that time, it was time for me to feed her and I went to put the nipple shield on and my daughter latched before I could even get the shield on. So, it was a simple adjustment for her and her neck that helped her latch on.
My sister-in-law who has a two-month old had a similar issue where her daughter was latching fine on one side but wasn’t latching very well on the other. I was using a nipple shield and then she went to our chiropractor and had an adjustment and she latched beautifully after that. So, I always encourage to take your babies to be evaluated.
ROBIN KAPLAN: It’s a body work – kind of like eating and suck amount as well because that’s huge.
ALICIA BRAVO: I was very fortunate that it was a very short experience with the nipple shield.
ROBIN KAPLAN: Yeah, definitely. MJ, we have a virtual panellist who wants to share some information?
MJ FISHER: Amy Renalo, she says, “I was using one for about a month and then accidentally left it at my parent’s house. Baby girl latch right on that day and we never looked back.” She said, “I locked out.”
ROBIN KAPLAN: I see a lot of my clients whose baby’s are on it for a while and then it’s right around that three month point where I was sudden the baby’s just like, “I don’t need it any more” and they get on. So, sometimes if it’s been a little bit of a battle up until then sometimes they will actually just the latch one just kind of like you were mentioning Alicia in just and never looked back.
ALICIA BRAVO: Yeah, I think that’s the biggest advice my lactation consultant had given me was: “Don’t panic. They usually grow out of it.” So, don’t ever think that it’s like the end of the world even though it feels like that in the moment.
ROBIN KAPLAN: Definitely. Kristina, what tips do you have for weaning off the nipple shield? Some of the moms mentioned, waiting until let down was over and then try to take it off – what are some good recommendations that you have?
KRISTINA CHAMBERLAIN: Yeah, I would say that’s a good one I hear a mom says is, “It’s most successful for them as where the baby starts with the nipple shield.” I call it “the bait and switch.” Take the nipple shield off and then they just don’t realize it or don’t care that you’ve taken it off like you can continue nursing. Sometimes, if you weren’t to not try the nipple shield at all and just go right through the breast, you can have baby stuck on your finger for a little bit just to help organize their suck.
Your finger is hard like the nipple shields so that might help them get that really strong message for their suck reflex. Once their suck is organized and they gotten that message – it might be easier for them to just latch on to the breast without the nipple shield. I have a lot of clients who tell me that they find it’s easier at night to not use the nipple shield than it is during the daytime.
I don’t know if you’ve heard that from your clients but I hear that all the time. I don’t know if it’s because everybody is a little calmer or more relaxed and if it’s their quiet time or there’s less stimulation or what. Our baby is if there’s still a little sleepy, they’re not going to protest not having the nipple shield as much. But, that’s one thing I hear over and over again that moms are even more successful at night than they are during the day when they’re trying to at first wean.
ROBIN KAPLAN: Sure.
KRISTINA CHAMBERLAIN: So, moms could also try to stay like they needed to still pump a little bit just to get their nipples to evert and kind of being more elongated for babies. That’s another thing you could do, just pump for a minute or two before you’d actually latch the baby on even with a manual pump.
ROBIN KAPLAN: Okay, even something that Katie had mentioned was she wanted to keep the breast the happy place. So, I hear a lot of moms ask, “What if my baby discontinues to cry at the bare nipple and cannot latch without the shield – should mom keep trying without the shield or should she instead kind of favour this that’s actually help our baby get on?”
KRISTINA CHAMBERLAIN: No, I mean I definitely would go for breastfeeding with the nipple shield over not breastfeeding at all or not having you know, a fun time with breastfeeding. So, for moms who find that their baby is really very frustrated and not happy with the breast, I definitely would say, “You give it a good old try and really try and get your baby to breastfeed unless you kind of figure it out for you know usually up to 15 minutes but at that point, I wouldn’t push it longer than that.”
I would recommend doing a lot of skin-to-skin with that baby as much as possible and just keeping baby always kind of near your naked chest. Sometimes babies just start off by looking in the nipple. Or just, they can smell the milk – they snuggle sometimes taking bath with them while they’re just next to the breast and kind of copes with them into – on their terms. They’re coming to the breast when it’s comfortable for them. Nobody’s pushing them. Sometimes that can also help the transition.
ROBIN KAPLAN: Okay and Jena had posted on our Facebook page. Is it possible to start using the shield during teething to help from getting nicked by the small sharp baby teeth? Often those top ones rather than those bottom ones that are covered by the tongue – is this something you would ever recommend?
KRISTINA CHAMBERLAIN: Well, I guess if the mom was finding that it was a problem over and over again, she could certainly try that again to protect. I wouldn’t think that that’s a – I haven’t had a lot of client myself who have started and continued using it for a long period of time during that. I feel like if your baby is latched on really well and they’re not easily distracted at the breast teething or teeth in out of self shouldn’t necessarily prevent breastfeeding from going well – you should be able to continue.
So, I would say, “She felt like she needed that to protect her nipples because she was getting bitten or something like that but I don’t think it would necessarily need to be use forever.” But then if baby is getting a lot of milk and getting well and has not affecting her supply then that works for them. I think that works for them.
ROBIN KAPLAN: Our panellist Katie had a question for you as well Kristina.
KATIE JACQUET REED: Hi. My question is about specifically pumping in supply with the nipple shield. I seem to be like two schools of thought with my son, I was told repeatedly I needed to pump as long as I was using the nipple shield because over time, it would lower my supply. So, I did and pump seven times a day after each feed for the whole duration. I actually had an abundant over supply and he never lost weight or anything.
I found out in retrospect that I was actually because of my oversupply that he was able to gain in spite of the tongue-tie because it basically would just gush into his mouth and he didn’t have to do much work. I mean with my daughter, I was told by a different set of folks that I did not have to pump because as long as she was removing milk, my supply shouldn’t be affected. Yet, when I did that in about three weeks, we had a crisis point because even though my supply normalized, she could not use her tongue to get it out.
So basically with both of my kids, they needed to have an artificially high supply in order to nurse effectively even with the shield. So, can you clarify like do we pump with the nipple shield or do we not pump?
KRISTINA CHAMBERLAIN: Well, it sounds like in your specific case, the bigger issue is that they are tongue tied in effect that because your daughter wasn’t diagnosed right so for a few weeks?
KATIE JACQUET REED: She was and she was clipped in the NICU but not far enough.
KRISTINA CHAMBERLAIN: So, regardless of your reason – a nipple shield are not or pumping or not, if she is enable to use her tongue, if her tongue function is compromised because of her frenulum then that’s what’s affecting your milk supply. So, if that’s the case and she’s not able to empty your breast then yes, pumping would help.
If she had a totally normal latch and her tongue-tied correction was adequate then you wouldn’t have to worry about it anymore in theory. What I would say is, “If somebody is using a nipple shield, I do recommend that they pump because I suspect baby is not going to be emptying their breast as well – either because reusing a nipple shield because baby doesn’t have a really strong or coordinated suck or the nipple shield is preventing their breast from getting all the stimulation it needs to like get the message.”
So, my recommendation would be to pump – if you’re using a nipple shield but if you’re having your baby weighed, I would recommend having your baby weigh every few days like every three to four days. Then, that includes the pre-impose read if you can do that because not only you’re checking baby’s growth pattern but also just transfer the doing pre-imposed weighed to see what baby is actually transferring at that time and that would kind of tell you to if you need to continue pumping or if you were pumping then you need to start pumping.
I think having really good follow-up can answer a lot of those questions. They don’t feel like, “I’m stuck pumping seven times a day forever.”
KATIE JACQUET REED: Yeah and with my daughter she transferred just fine. So, that’s why everyone was kind of perplexed but it’s only because of my oversupply that she was able to make that happen. So, the paediatrician that was working with us told me, “No, you don’t have to pump because look, she’s transferring enough milk and yet three weeks later once I stop pumping – that’s when she started losing weight.”
KRISTINA CHAMBERLAIN: I mean it’s nice that your supply to compensate but there are tricks everybody. I mean I have seen that happen. So, but if you were stop pumping – helpfully you would still have your baby follow up after that, you were not pumping for such a long period of time that you had to work so hard to get your supply back up.
That’s what I’m saying kind of, “Continue to have follow-up every few days.” Check in baby’s weight even after you stop pumping to make sure that that really is the right plan for you guys.
ROBIN KAPLAN: Thank you. Well thank you so much Kristina and to our panellists for sharing this incredibly valuable information about The Do’s and Don’ts of Nipple Shields. For our Boob Group Club members, our conversation will continue after the end of the show as Kristina will discuss how the nipple shield can be helpful for getting baby back to breast when the baby is only taking a bottle.
For more information about our Boob Group Club, please visit our website at www.TheBoobGroup.com .
AUTUMN BONNER: Hi Boob Group. My name is Autumn Bonner. I’m the co-owner and founder of Tailored Fitness an online video based workout program for moms. I’m here today to give you some tips on exercising after having your baby. Did you know that caring for a newborn can wreak havoc on your posture?
The weight of your breast leaning over while nursing and changing diapers and carrying your baby in cradle hold – all cause your shoulders to hunch forward. This makes your chest muscles tight while the muscles in your middle and upper back grow weak. Luckily, regular exercise can help you get your posture back. Good posture instantly makes you appear slimmer and feel more confident.
To strengthen the muscles in your back, try this exercise. With your arms straight out in front of you spaced about shoulder-width apart, hold your resistance band with both hands. Keeping your arms straight, pull your hands apart stretching the band and bringing your shoulder blades together in the back, keep going until your arms are straight out to your Return slowly to the starting position and repeat for two sets of 10.
Just stretch your chest muscles; open your arms wide to a T Position and hold for 30 seconds. To learn more great exercises created just for new moms, check out our videos at MyTailoredFitness.com and keep tuning in to The Boob Group for more great tips on exercising postpartum.
ROBIN KAPLAN: That wraps up our show for today. We appreciate you listening to The Boob Group. Don’t forget to check out our shows, “Preggie Pals for expecting parents” our show, “Parent Savers for moms and dads with newborns, infants and toddlers” and our brand new show, “Twin Talks, that talks about caring for twins from pregnancy through age five.” Thanks for listening to The Boob Group, your judgment-free breastfeeding resource.”
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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