A nipple shield is a thin, flexible, silicone nipple-shaped cover you place over your nipple and areola (the area around the nipples). It has holes at the tip, allowing milk to flow.
Nipple shields can provide short-term help with some breastfeeding problems.
A lactation nurse or midwife or your PHN will give you advice about using a nipple shield, if they think you need it.
They can explain how it works and:
- help you choose the right size nipple shield
- show you how to apply it correctly
- show you how to feed your baby with a nipple shield
- support you to phase out nipple shields
When you might need a nipple shield
Nipple shields can be effective in certain situations.
A lactation nurse or midwife or your PHN may recommend nipple shields if you or your baby have problems positioning and attaching (latching).
This can happen, for example, if:
- you have nipple pain or flat or inverted nipples
- your baby is used to bottle feeding
- you are breastfeeding a premature baby
Nipple shields will not fix a poor latch, sore or cracked nipples. But they may make feeding more comfortable.
When not to use nipple shields
Nipple shields are not usually used until your milk comes in. This is usually about 2 to 3 days after birth.
If there are issues with latching or a premature birth you may need to use them sooner.
Before using nipple shields
Before using nipple shields make sure that:
- a lactation nurse or midwife has checked your baby’s positioning and attachment
- you've tried the laid-back breastfeeding position
- you've used a breast pump or hand expressed to soften or shape flat or inverted nipples
- you've expressed breast milk to help with supply
- you're doing increased skin-to-skin contact
Risks from using a nipple shield
Your breasts do not get the same stimulation when using a nipple shield.
The thin silicon cover can stop your body getting the signals it needs to make milk. This can lead to reduced milk supply and your baby not gaining enough weight.
Other risks with nipple shields may include:
- blocked ducts, breast abscess and mastitis
- becoming dependent on using them
- damage to your nipple if they do not fit properly
- using them on their own will not resolve a poor latch
When using nipple shields
It is important to use a nipple shield correctly so it does not cause more problems for you or your baby.
For example, your baby cannot get proper attachment to your breast if they only have the tip of the shield in their mouth.
Nipple shield sizes
Nipple shields come in different sizes, based on the size of your nipples.
A nipple shield that is too large may:
- stop milk passing to your baby properly
- reduce the amount of milk your body makes
- make it too difficult for your baby to feed
Nipple shields that are too small will not go far enough into your baby’s mouth. This can make feeding painful. It can also stop deep attachment to the breast.
Getting help to get the size right
A lactation nurse or midwife or your PHN can advise you on choosing the correct size.
Check the diameter at the base of the nipple and the length of the nipple, to help get the size right.
You may need different nipple shield sizes for each breast if you have different-sized nipples.
Nipple shields may not be available for very large nipples. Trying to fit a large nipple into a nipple shield that does not fit can cause further pain.
How to put on a nipple shield
Hold the nipple shield between the thumb and forefinger of each hand.
Stretch the nipple shield almost inside out before applying. Place the shield over the nipple with the base of the shield close to the base of the nipple. Release the stretch.
This creates some suction that helps draw the nipple in. This suction helps keep the shield in place.
Smooth the edges of the nipple shield onto the breast.
Moistening the edges of the shield at the base will help keep it in place.
For more details, follow the instructions that come with the shield.
Position during feeding
Make sure you cannot see the rim of the shield when your baby is sucking. Try to stop your baby's mouth sliding down the shield during a feed.
Gently hand express for a few minutes before feeding. You can also express a little milk into the nipple shield.
This helps start the milk flow and encourages your baby to keep feeding. It can also stop your baby from sucking too hard at the beginning, which can sometimes be painful.
Cleaning nipple shields
Follow the manufacturer's instructions to clean and sterilise shields before using them for the first time.
If you are using nipple shields in the hospital, wash the nipple shield thoroughly in hot soapy water and sterilise it before each use.
If you are using a shield at home and your baby is a healthy, full-term baby, wash it after each use.
Follow the steps:
- Clean with hot soapy water.
- Rinse the shield.
- Dry completely.
- Store in a clean, dry container.
You can also wash it in a dishwasher on a hot cycle.
Monitoring milk supply
Monitor milk supply and your baby’s weight when using nipple shields.
Do this by:
- counting your baby's wet and dirty nappies
- making sure your breasts are soft after feeding - hand express or use a pump until they feel soft
If you are worried about your milk supply you can contact your hospital’s lactation nurse or midwife or your PHN.
Expressing breast milk by hand
Using a pump to express breast milk
Signs your baby is feeding well
Signs your baby is feeding well with a shield include:
- there is breast milk in the shield
- your breasts feel softer after a feed
- your baby is active at the breast and you can hear them swallowing
- your baby is gaining enough weight
- your baby has relaxed hands and does not fuss after a feed
If your baby is less than 7 days old, they should have at least 2 large yellow poos and 6 heavy wet nappies each day.
Phasing out nipple shields
Talk to your PHN, lactation nurse or midwife about how to stop using nipple shields.
To start phasing out the shield, they may advise you to:
- start a feed with a nipple shield in place
- take your baby off your breast after few minutes
- try immediately to latch your baby on again without the shield
It is usually possible for a baby to learn to breastfeed without the shield. But it can take time and you may need support.
Nipple shields are different to breast shells
Nipple shields are not the same as breast shells.
Breast shells are hard protective covers worn inside your bra. They put gentle pressure on the areola to help draw out your nipples.
Related topics
Positioning and attaching your baby to the breast
Breastfeeding with flat or inverted nipples
