Nipple Shields for Breastfeeding: Risks & Benefits

A nipple shield can be a helpful tool for some breastfeeding parents, but it’s not a one-size-fits-all solution. While it can assist with latch issues and nipple pain, improper use may cause more harm than good. Before using a nipple shield, it’s crucial to consult a lactation consultant to ensure it’s the right choice for you and your baby.

What is a Nipple Shield?

A nipple shield is a thin, flexible silicone cover that fits over the nipple during breastfeeding. It is often used to help babies latch, especially when dealing with challenges such as flat nipples, long nipples, nipple fissures, or when a baby has difficulty sucking effectively. Some parents also use nipple covers to protect sensitive or sore nipples during feeding.

Nipple shields are typically made of soft, BPA-free silicone and come in different sizes to accommodate various nipple shapes and baby preferences. Some shields have a cut-out design to allow for greater skin-to-skin contact, which can help babies transition to direct breastfeeding more easily. 

Nipple shields come in different sizes and it might take some trial and error to find the right fit. Generally it is recommended to choose the largest size that works for you and baby. The larger area allows your nipple to stretch and move freely without rubbing against the sides and causing restricted milk flow. Some people require different sizes from breast to breast. 

While nipple shields can be a temporary solution, they should not be used as a long-term fix for breastfeeding difficulties. Working with a lactation consultant ensures that any underlying issues—such as a poor latch or lip-tie—are properly addressed.

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Risks of Using a Nipple Shield

While a nipple shield can be beneficial in some cases, it also carries risks, including:

• Reduced milk transfer: A shield may interfere with the baby’s ability to extract enough milk, potentially affecting weight gain.
• Decreased milk supply: If the baby isn’t effectively removing milk, the body may produce less over time.
• Latch dependency: Some babies become reliant on the shield and struggle to feed without it.
• Infection risk: If not properly cleaned, bacteria or yeast can accumulate, leading to infections.

Who Should Not Use a Nipple Shield?

A nipple shield is not the right solution for everyone. You should avoid using one if:

• You haven’t consulted a lactation consultant: Using a shield without professional guidance may lead to ineffective feeding, supply issues, or difficulty weaning off the shield later.
• Your baby has a weak sucking reflex or oral motor difficulties: Some babies may require alternative interventions, such as feeding therapy, instead of a nipple shield.
• Your baby is struggling with weight gain: A shield can sometimes reduce milk transfer, which may not provide enough nourishment for babies who need to gain weight.
• You have recurring nipple infections or fissures: While a shield may provide temporary relief, it’s important to address the root cause of nipple pain rather than relying on the shield as a long-term solution.

How to Use a Nipple Shield

If a lactation consultant recommends a nipple shield, follow these steps for proper use:

1. Choose the right size: The shield should fit snugly over your nipple without being too tight or too loose. You may need to try a few different size nipple shields to find the one that fits most comfortably.
2. Moisten the shield: A bit of water or breast milk can help the nipple shield adhere better to your skin
3. Invert and apply: Flip the shield halfway inside-out, place it over the nipple, and smooth it down so it sticks securely.
4. Ensure a proper latch: Guide your baby’s mouth onto the shield, ensuring they get a deep latch to encourage effective feeding. 

How to Put on a Nipple Shield

For the best fit and function, follow these steps to put on a nipple shield:

1. Wash your hands thoroughly.
2. Invert the edges of the nipple shield slightly.
3. Center the shield over your nipple and press gently to create a seal.
4. Check that your nipple extends into the shield’s tip for proper milk flow.

Then, look for these signs that you’ve put on a nipple shield correctly:

• Your nipple extends into the tip of the shield without discomfort.
• The shield adheres snugly to your skin without slipping or moving excessively.
• Your baby maintains a deep latch and is actively sucking and swallowing milk.
• There is no excessive clicking sound while your baby nurses.

Most importantly, when you’ve put on a nipple shield correctly, your baby should appear satisfied after feeding and continue to gain weight appropriately.

How to Clean a Nipple Shield

Proper cleaning of a nipple shield is essential to prevent bacteria buildup and help prevent infections for both parent and infant. After each use, wash the nipple shield with warm, soapy water and rinse thoroughly. Keep the nipple shield in a breathable container such as a clean cotton bag to prevent molding in between uses.

You should also sterilize your nipple shield regularly, by boiling in water for 5 minutes or using a steam sterilizer.

How to Wean Off a Nipple Shield

If your baby has become reliant on a nipple shield, consider consulting with a lactation specialist to help you gradually transition away from it. They might suggest tips for weaning such as:

1. Start feeds with the shield: Once milk starts flowing, remove the shield and offer the breast directly.
2. Try skin-to-skin contact: Encourage your baby to latch naturally without the shield.
3. Use breast compressions: This helps maintain milk flow and keeps your baby engaged without the shield.
4. Be patient: Some babies adjust quickly, while others may need more time to wean off a nipple shield.

A nipple shield can be a useful temporary aid, but it’s not a long-term fix for breastfeeding issues. It’s essential to work with a lactation consultant to determine whether a nipple shield is right for you and how to use it safely. By following best practices and ensuring proper cleaning and weaning techniques, you can support a successful breastfeeding journey for you and your baby.