Nipple Shields and Breastfeeding
By Kaya Thorpe, IBCLC. Revised March 2022
There is a lot of misinformation around nipple shields. Some people dislike using them while breastfeeding, others use them to fix everything. Nipple shields can be a useful tool with breastfeeding but should always be used in conjunction with good breastfeeding support.
What is a nipple shield and why would I use one?
Nipple shields are made of silicone and are placed over the nipple before a breastfeed. They look like a little hat! The most common reason we find people are using nipple shields is due to pain while breastfeeding. While they can be useful for helping with pain while breastfeeding it is important to get to the bottom of why you are in pain first. If it is linked with positioning and attachment, you will still find you are struggling with pain when using the shield.
Nipple shields were actually developed for supporting premature or unwell babies to breastfeed. By placing them over the nipple they create an additional layer of negative pressure which can help babies who are struggling to transfer more milk at the breast.
How do I choose which shield?
There are many nipple shields on the market currently. The best option is one that comes in multiple sizes and is a comfortable fit. Most of them now have cutaways either on the top or bottom of the nipple shield. The shield needs to fit over your nipple before a feed with space as your nipple tends to enlarge during breastfeeding. During a feed your nipple should not be rubbing against the shield sides, afterwards there should be space around the edges and the nipple should not be rubbing against the top of the shield.
Putting on a nipple shield
Getting a nipple shield to stay on your nipple can feel like a challenge especially with a screaming baby. Following these steps should help
Get your shield and roll the edges up so that it looks like a sombrero hat for your nipple
Make sure your breast is dry and not too much breastmilk has leaked as this can make it harder to apply the shield – difficult with a screaming baby especially in the early days.
If your shield has one cut away. Some people say position the cutaway to babies nose, some to babies chin. Try both and see what works for you. You may find baby doesn’t like the shield near their nose, you may find it much easier to latch baby to the breast with their chin being clear and not hitting a shield. Always make sure that the shield cutaway lines up with how you want to latch baby. Different positions will mean that the shield will need turning.
Place the shield down and over your nipple. Push the shield down onto your breast so the sides roll down. Flatten the shields out from the middle towards the edges.
Make sure the sides of the shield are flat against your breast. The shield should feel like it will stay on the breast and not immediately fall off
Making sure the shield is warm can be useful alongside dampening the flat edges to help them stick down.
Step 1 - Roll your shield like a sombrero hat and place down and over your nipple
Step 2 - Push the shield down the flange and onto your breast. Flatten the edges from the middle outwards
One picture shows a shield correctly applied, the other picture shows one just placed onto the nipple
It is important to remember when using a nipple shield you must still working on making sure your baby latches well. Using breast shaping can be really helpful. See our piece on positioning and attaching for help.
Using a nipple shield
When using a nipple shield we will often suggest that you pump after a feed. This is often suggested because you may be needing to give your baby top up feeds of breastmilk to support breastfeeding while baby gets to grips with feeding. Commonly we use nipple shields when families are struggling to find relief from painful feeding, to support a baby returning to the breast after lots of bottles, to support with premature babies and those who may have issues with their palate shape.
We suggest you steralise your shield once per day and between feeds wash with hot soapy water between feeds and store in a clean bag or box. If your baby is premature or has health concerns you should steralise after every feed,
Weaning off nipple shields
Depending on why you start using nipple shields may influence how quickly you can get rid of them. Some families will use them for months others just a few weeks. If you have used nipple shields for painful feeding you may find removing the nipple shield can become a scary idea. Make sure you get your latch correct first before you try and remove the shield.
Try starting the feed with the shield and removing part way through the feed,
Deep breast shaping and trying to make your breasts feel as firm as possible can help baby latch well
Some babies may latch straight away without a shield but refuse at other times. Removing the shield can be a gradual process.
If you have been using a shield due to baby struggling to transfer milk ensure you have regular weight checks booked to make sure they are able to transfer milk well enough to gain weight..
Don't worry if you feel like feeding takes a step backwards when you start to remove the shields. Get your latch checked by an expert and keep working on it.