Nipple Shields: How & When To Use One

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Nipple shields can be a lifesaver when it comes to breastfeeding your child and lessening the pain and discomfort when baby nurses.

It can be beneficial especially if you have sensitive and sore nipples. Nipple shields are also useful if your baby is dealing with issues like difficulty in latching, or they have conditions like being tongue-tied.

Keep in mind that they should only be used as a temporary solution to help mothers deal with these various issues. The key is to use the nipple shield properly in order to make the most out of it and wean baby off correctly.

What is a nipple shield?

A nipple shield is mostly made of flexible, thin, and soft silicone but sometimes it can also be made of rubber, latex, wax, or glass.

The best nipple shield to use is the thin silicone kind since they last longer and is also easier to clean. There are also nipple shields that have a cut out that allows more skin-to-skin contact.

Nipple shields are placed over mom’s nipples and areola area during feeding. It creates a definite shape that the baby can easily latch onto. It acts as a barrier to protect sore, cracked, and sensitive nipples so that baby can still breastfeed.

It has a small opening at the tip where the milk can flow out and baby can easily get milk from.

When should you consider using a nipple shield?

Baby has difficulty in latching on

Sometimes babies can latch better to a more defined, artificial nipple shield compared to mom’s actual nipple.

Premature babies

As preemies are still learning how to latch on mom’s nipple, it might be easier for them to latch unto a smaller nipple shield and it will also use lesser energy to try to stay latched on to the nipple shield compared to the real thing. As they start to grow, they can then be weaned and start to nurse directly on mom’s breast.

Tongue-tied babies

Some babies are born with this condition called ankyloglossia wherein the tissue connecting the tongue to the bottom of the mouth is tight, short, or thick, making it harder for baby to move it freely or latch unto your breast.

They will also have a hard time sucking milk from the breast. A nipple shield can help babies breastfeed even with this condition.

Flat, retracted, or inverted nipples

If your nipples are flat or inverted, baby could have a difficult time latching on so a nipple shield can help with drawing out the nipple and making baby latch on.

Sore, cracked, and dry nipples

A nipple shield for sore nipples can greatly help mom who wants to breastfeed baby but is finding it really excruciating to do so.

If your nipples are irritated or dry, it could get really painful to breastfeed so by having a nipple shield, you can breastfeed with lesser amount of pain and discomfort and protect your breasts at the same time.

From bottle to breast

If your child is not used to breastfeeding and you are trying to let them get used to it from being bottle fed, a nipple shield will help with this transition.

Nipple confusion

If your baby has nipple confusion, you can use a nipple shield on and off to help baby start to get used to breastfeeding off your actual nipple.

How to put on a nipple shield

A nipple shield should have a small space between the crown of the nipple shield and your nipples. If there is no space at all, it could mean the size is too small for you and it might lead to a sore/bruised nipple.

On the other end, if the space is too big, baby might not be able to draw out milk properly or they might gag. You can also check if you have the right nipple shield size during post feeding. If your nipples feel cracked or sore, it could mean that you have the wrong size.

Example of nipple shield sizes: 16 mm (small), 20 mm (medium), 24 mm (large). Newborns will most of the time, do well with a small sized nipple shield.

Turn the nipple shield inside out halfway and place on the nipple.
Adjust the shield on the nipples and draw out the tip. Make sure that your nipple is inside the nipple of the shield (meaning in the tip of the nipple shield).
You can moisten the shield with breast milk in order to seal it in place.
You can hand express milk unto the nipple shield tip to help your baby start nursing.

Using nipple shields properly

– Your nipple shield should be thoroughly cleaned and sterilized before using it.

– You can rinse the nipple shield with warm and soapy water to soften it up and make it easier to put on the nipples but only use the nipple shield dry.

– Like nursing with a bare nipple, when using a nipple shield, baby should have the entire nipple shield in his/her mouth in order to stimulate mom’s milk and also get enough milk.

– The jaw area should be close to the breast and but not on the shaft of the nipple shield. In order to help baby latch on, use one hand to hold his neck/head and the other hand to hold your breast and help baby get his/her mouth/nose close to your breast. His mouth should be opened wide so baby won’t be only getting air and not the actual breast milk.

– His lower jaw should also be moving which means he/she is not taking in air.

If you are using a nipple shield with a cut-out, the cut out should be beneath the baby’s nose.

– Make sure the baby isn’t sliding on and off the nipple shield since this will only cause pain and milk supply won’t be properly transferred.

– Squeeze out a bit of breast milk unto the nipple shield.

– Touch the crown of the nipple shield to the roof of the baby’s mouth. This will help the baby to get the milk down and also pause to breathe.

– During the course of using the nipple shield, make sure you are evaluating if baby is getting enough milk by counting wet diapers (at least five to six wet diapers a day). Baby’s stools should also be regular (at least three times a day for a four to six-week-old baby). As your baby grows older, the frequency of stools could be less but he/she should still have some loose stool.

– You should also see and check that baby is gaining weight well.

– During feeding, listen for frequent swallowing/soft gulps and check if your breasts become soft after. If not, you will still need to pump in order to prevent clogged ducts and also keep up your milk supply.

– There are various nipple shield sizes and shapes. Make sure your nipple shield fits your breast/nipple perfectly. It is not one size fits all and the wrong size could block the milk flow instead.

– If your breast isn’t completely drained after using the nipple shield during feeding, do some pumping to remove the remaining milk.

– Ideally, you should wash the nipple shield after every feeding. Rinse in cold water and wash with hot soapy water. Make sure to rinse well and store in a clean, dry place.

– You can also boil your nipple shield once a day in a pot of water for 20 minutes.

– You can go to a breastfeeding consultant to see if you are using the nipple shield properly and if there are things you can improve on.

Pros to using a nipple shield

Mom’s sore/cracked nipples can heal but you can still breastfeed baby without introducing the bottle yet.
If your baby is premature or even sick, they most likely will get tired easily and won’t latch on correctly so by using the nipple shield, they can breastfeed better and more easily.
Nipple shields can help baby to learn to latch on properly and breastfeed correctly.

Cons to using a nipple shield

Difficulty in weaning especially if baby gets too attached to the nipple shield.
If not used properly, baby could get lesser milk and might need supplementation.
If there is a reduced milk transfer, there could be a risk for getting mastitis/clogged ducts.
Mom’s milk supply could decrease if milk transfer isn’t stimulated properly.
If the nipple shield isn’t the right size, mom could feel pain.

How long should you use a nipple shield?

Once your baby has already learned to latch on properly and breastfeed effectively, you can start to wean the baby off it. Nipple shields should only be a temporary/short-term solution for moms who need them.

Weaning off a nipple shield

– Weaning should be a gradual process and not a sudden one.

– Make sure baby has a good latch and position- baby’s whole body should be facing yours and he/she shouldn’t have to turn his head. Make sure the mouth is opened wide (like a yawn) before you try to get baby to latch. Baby’s chin and nose should be touching your breast. The lips should be flanged out and if they aren’t, you can manually flip it out yourself.

– Pumping before nursing – this will encourage a letdown and baby will get rewarded right away.

– Let baby suck on your finger for a few minutes so that they will get used to sucking on while dropping his tongue.

– Breastfeeding often – you can try breastfeeding when baby is sleepy or half awake since they are willing to take the breast more. Try to nurse baby before they cry or get hungry.

– Nurse while walking, swaying, moving, etc.

– Do as much skin-to-skin contact when you are breastfeeding.

– Do different nursing positions like standing, lying down, or sitting.

– If baby is upset while you are trying to nurse, try to calm him down first before trying again.

– Try switching the nipple shields when baby is not hungry/still full.

– If you are switching breasts, you can also switch the nipple shields since the baby is still feeding.

– Apply ice to the nipple to harden it but wait a little while before feeding the baby.

– Take note of what times during the day when baby is more receptive and you can use those to your advantage.

– Compress your breast and hold it firmly so that the nipple will become firmer like the shield until the baby is sucking well and then let go.

– If baby still won’t feed without the shield, keep the shield on until baby is already nursing well and you can slowly remove it.

– When you are using the nipple shield to give your nipples time to heal, try to use it only on the side with the cracked/sore nipple. If possible, use it only on some feedings and not all the time.

– If you are using the nipple shield to help baby latch on, try every day to let baby latch on without it or after using the nipple shield and baby latched, remove it and quickly encourage baby to latch back on.

– If you are using the nipple shield because of baby’s tongue-tie, mouth issues etc., you might want to consult a lactation consultant so that you won’t increase your risk for breastfeeding challenges and be totally dependent on the nipple shield.

Nipple shields should only be used if necessary and the right precautions are taken in order to ensure you are using it correctly. You can seek the help of a lactation consultant to guide you accordingly.

Some moms would rather use nipple shields so that they can breastfeed their baby compared to not breastfeeding them at all. Sometimes you need a little time and patience when it comes to breastfeeding and using a nipple shield and weaning baby off it is no different.

In order to make the most out of the nipple shields, make sure you use it properly as a tool to help you and your baby in making the most out of the breastfeeding experience.