What is a Nipple Shield?

A nipple shield is a thin piece of silicone material that creates a barrier over your nipple when breastfeeding.. Nipple shields are soft, flexible, and come in different shapes and sizes. Nipple shields can temporarily bring you relief from sore nipples or help your baby to latch.

Do I Need a Nipple Shield?

Most moms will not need a nipple shield, but research has shown that temporarily using a shield under certain circumstances could lengthen the breastfeeding relationship when also working with a lactation specialist.^1,2,3 If you experience pain while feeding or your baby is having a difficult time latching, it’s best to first try to correct those issues by working with a lactation specialist who can provide strategies and care without a shield. When no other solution to pain or latch problems can be found, your lactation specialist may recommend using a nipple shield. Typically, a shield is used for a short period of time while continuing to try to address the challenges of feeding your baby directly at the breast.⁴ 

The reason nipple shields are typically a temporary tool is because nipple shield use has been linked to low weight gain, clogged milk ducts, low milk supply, and other common breastfeeding issues.⁴ You can help avoid those potential problems by thinking of the shield as a short-term tool. Ideally, the main goal is to breastfeed without a nipple shield. 

Here are some situations where you and your lactation specialist may want to try a shield if other techniques are not working.⁵ 

• Premature Babies
  If your baby was born before 37 weeks gestation, he or she may benefit from a nipple shield. The shield may aid in a more efficient latch until your baby is older and stronger and his or her suck is more coordinated. 
• Sore or Cracked Nipples
  Using a shield could provide temporary relief from pain giving your nipples time to heal while you and your lactation specialist address the reason for the nipple damage and to prevent further damage. 
• Preference for Artificial Nipple
  Sometimes babies who drink from a bottle regularly start to prefer a bottle and may not know how to nurse directly from your breast. It may take time to help your baby learn how to transition from the bottle to the breast. During this process, a nipple shield can provide a hard surface at the roof of the baby’s mouth similar to an artificial nipple. This will encourage your baby to suck effectively while also stimulating mother’s milk supply. 
• Flat or Inverted Nipples
  If you have flat nipples or nipples that retract inward, a shield may help baby latch. Stimulating your nipple to draw it out before latching with a shield can be helpful. Over time, most flatter nipples will naturally evert more and more with breastfeeding. If your nipple doesn’t eventually draw out so that your baby could more easily latch onto it, your lactation specialist may suggest using the nipple shield long term.

How to Use a Nipple Shield⁵

[Photograph of nipple shield). (2016). https://laleche.org.uk/nipple-shields/

1. Ensure you have the correct size. Measure your nipple diameter before pumping or breastfeeding. Find a nipple shield closest to your size.
2. Pull back on the edges of the shield turning it halfway inside out. Place your nipple in the tip of the shield. Unfold the edges over your areola. The shield should fit securely over the nipple and areola.
3. Place nipple cream or a few drops of water or breast milk on the outer edge. This can help keep the shield in place.
4. If needed, express a few drops of breast milk into the shield to encourage your baby to latch.
5. Look for signs of good milk transfer. You should see milk in the shield when your baby unlatches from the breast. Work closely with your lactation specialist to ensure your baby is transferring enough milk to grow and thrive.

Cleaning instructions

• After each use, wash in warm soapy water.
• Store between uses in a cool, dry place. 
• Sanitize once per day using a sanitizing microwave bag or boiling for 5 minutes.⁵

Weaning From a Nipple Shield

Nipple shields are meant for temporary use. In most cases, the goal is to wean from using one.⁵

• Feed your baby skin-to-skin and offer the breast at early feeding cues. Crying is a late sign of hunger. A fussy baby will be much harder to latch. 
• Bait and switch can be an effective technique. Start breastfeeding with the shield, slide it off, and quickly reattach the baby directly to the breast. This approach can take patience and practice. 
• Contact your lactation specialist if having trouble weaning from the shield.

What If I Have Questions?

If you are interested in learning more, this Aeroflow class expands on some of the topics discussed above:

• Lactation Q&A

Want More Info?

For a directory of Aeroflow’s other Care Guides offering information on pregnancy, baby care, and more, browse our comprehensive list of titles:

References