Nipple shields cover your nipples to protect them during breastfeeding.
They can provide short-term help with breastfeeding problems but can cause your body to produce less milk.
Ask your public health nurse (PHN), midwife or lactation consultant for advice before using them.
When you might need nipple shields
Nipple shields might be recommended if there are problems positioning and attaching (latching) your baby to your breast.
This can happen if:
- your baby has tongue tie or other tongue issues
- you have flat or inverted nipples
- your baby is used to bottle feeding
- you are breastfeeding a premature baby
Nipple shields won’t fix sore or cracked nipples but they can make feeding more comfortable until the cause is found.
When not to use nipple shields
Nipple shields are not usually used until your 'milk comes in' 2 to 3 days after birth.
If there are issues with latching or a premature birth they may be recommended for use sooner.
Before using nipple shields
Before using nipple shields make sure that:
- your baby’s positioning and attachment have been checked by a lactation specialist or midwife
- you've tried the laid-back breastfeeding position
- you've used a breast pump or hand expressing to draw out flat or inverted nipples
- you've expressed breastmilk to help maintain supply
- you're doing increased skin-to-skin contact
Risks
Your breasts do not get the same stimulation when using a nipple shield.
The thin silicon cover can reduce the signals your body needs to make milk. This can lead to reduced milk supply and your baby not gaining enough weight.
Other risks with nipple shields include:
- blocked ducts, breast abscess and mastitis
- becoming dependent on using them
- damage to your nipple if they don’t fit properly
Using nipple shields
Using your nipple shields correctly is important.
Choose the right size
Nipple shields come in different sizes based on the size of your nipples. Ask your PHN or midwife for advice on how to measure properly.
A nipple shield that is too large may:
- not transfer milk to your baby properly
- affect 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 stops deep attachment to the breast.
Some types are called ‘contact nipple shields'. These shields have a cutaway portion so your baby has close contact with your skin. This also helps them to smell your milk.
How to put it on
Follow the instructions that come with the shield to put it on correctly. Your baby can't get a proper attachment to your breast if they only have the tip of the shield in their mouth.
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.
Cleaning
Follow the manufacturers instructions to sterilise shields before using them for the first time.
After each use:
- Clean with hot soapy water.
- Rinse.
- Dry completely.
- Store in a clean, dry container.
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 empty 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 specialist or your PHN. You could also find a private lactation consultant on the Association of Lactation Consultants in Ireland website.
Signs your baby is feeding well
Signs your baby is feeding well with a shield:
- there is breastmilk in the shield
- your breasts feel softer after a feed
- your baby is active at the breast and you can hear 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 lactation consultant or PHN about how to stop using nipple shields.
Close monitoring will help them decide if you're ready to start breastfeeding directly from your breast.
Other nipple and breast products
Nipple shields are different to other nipple and breast products.
These include:
- breast shells - hard protective covers worn inside your bra
- silver cups - to protect nipples from friction with clothes
