We recommend the Medela Contact Nipple Shield.
You should be using a size Medium unless specifically directed otherwise. Shields are fitted based upon your nipple diameter, not based upon the size of the baby’s mouth.
Hint: If you pump with a size 24 mm (M) or larger flange, you should be in a size Medium nipple shield.
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Applying the nipple shield
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Partially invert the nipple shield and center it on your nipple. The cut out of the shield should be placed where the baby’s nose will land. Sometimes the plastic flips back on the baby’s face. That’s ok. If the cut out is in the right spot, there is no worry that the plastic will block baby’s nose.
Checking placement of the shield
Before latching baby on, make sure your nipple is centered in the shield. It shouldn’t be squashed off the one side (that will hurt when baby latches!)
Latching baby onto the shield
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Utilize the same techniques to achieve a deep latch as you would without the shield, but align the baby’s mouth with the shield rather than placing the nipple on the baby’s nose. Wait for baby to open wide and then push him on quickly and assertively from the shoulder blades. Baby should start sucking right away. If he pulls his head back, let him, then try again.
- Applying the nipple shield: Partially invert the nipple shield and center it on your nipple. The cut out of the shield should be placed where the baby’s nose will land. Sometimes the plastic flips back on the baby’s face. That’s ok. If the cut out is in the right spot, there is no worry that the plastic will block baby’s nose.
- Checking placement of the shield: Before latching baby on, make sure your nipple is centered in the shield. It shouldn’t be squashed off the one side (that will hurt when baby latches!)
- Latching baby onto the shield: Utilize the same techniques to achieve a deep latch as you would without the shield, but align the baby’s mouth with the shield rather than placing the nipple on the baby’s nose. Wait for baby to open wide and then push him on quickly and assertively from the shoulder blades. Baby should start sucking right away. If he pulls his head back, let him, then try again.
Checking the latch
Once the baby is latched onto the shield, check the following:
- You should feel a strong tug, not a sharp pinch. If you are feeling a sharp pinch, the shield may be crooked on your nipple or the shield may be too small. Adjust and try again.
- Both lips should be flayed out like a fish. With the shield, it is acceptable to manipulate baby’s mouth to make this happen, or unlatch and re-latch.
- Baby’s lips should be touching breast tissue and you shouldn’t see the nipple portion of the shield popping in and out of the baby’s mouth. If this is happening, pull the baby’s body in closer to you and angle the baby’s head so his chin is deeper and his nose falls slightly away from the breast like he is drinking from a glass.
Make Sure Your Shield is Working
- After nursing, you should see a little milk left in the nipple shield.
- Once your milk is in, you should hear and see the baby swallowing.
- Your breast should feel softer after feeding
- Baby’s weight gain and diaper count should be within normal limits.
- You should not feel pain while nursing.
- The baby should seem satisfied after nursing on one or both breasts ( remember to always offer the second breast!)
How to Wean from the Nipple Shield
- There is no particular time you must get off a nipple shield. Some women need it for a few days, others for a few weeks. When you are ready to start trying, follow these suggestions.
- Attempt at a time when both you and baby are feeling patient and in a good mood (not 3am!).
- Try Nursing with the shield first, then taking the shield away and attempting a latch.
- Try before baby gets very hungry, right when you see early hunger cues.
- Spend lots of time skin-to-skin. Try bathing together and letting your baby try to find the nipple on his own.
- Get help before getting too frustrated. If your first few attempts aren’t going well, or the latch is really painful without the shield, schedule an appointment with your lactating consultant. Nursing with a shield is quite different than nursing without and there are a few techniques that have become second nature that now need to change. Don’t feel like you have to do this alone!
When to Seek Help with Your Nipple Shield
- If you have a persistently painful latch with or without the shield
- If baby isn’t gaining weight well or having adequate diaper output.
- If you are trying to stop using the shield and you cannot obtain a comfortable latch or get baby to latch at all!
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