How to Use a Nipple Shield

What is a nipple shield?

A nipple shield can be a really useful tool for various reasons throughout your breastfeeding journey. A nipple shield, defined by the Australian Breastfeeding Association (ABA), is a thin silicone cover that you place over your nipple while breastfeeding, recommended by a healthcare professional. 

Nipple shields contain holes in the tip which allows the transfer of breastmilk to your baby, providing a teat formation that may make it easier for baby to latch and can ease discomfort while feeding if your nipples are tender. In most cases, the use of a nipple shield is only temporary until your baby improves their latch or breastfeeding feels more comfortable for you.

Reasons you might need to use a nipple shield:

• If baby is premature or having difficulty attaching to the breast

• Flat or inverted nipple/s

• Sore or cracked nipple/s

• An oversupply of milk that is affecting your baby’s latch

• If baby has been bottle-fed and is transitioning to the breast, a nipple shield can be more familiar for them to latch onto

Breastfeeding is a learned skill and it can take time for both you and your baby to get the hang of it. During this, your nipples can become quite sore which can make feeding difficult. A nipple shield works by providing a barrier between your nipple and your baby’s mouth, which means it can help relieve discomfort and give your nipples time to heal while your baby is learning to breastfeed. A nipple shield also provides a firmer larger target if your baby is having trouble latching to the breast, which is common if the baby is premature or you have flat or inverted nipple/s.

Before introducing a nipple shield it is important to try other possible solutions to solve the issue and always seek professional advice from a midwife or lactation consultant. It is critical to get to the root of the problem with an expert for a long-term plan to increase your likelihood of a positive breastfeeding experience.

Nipple shield sizes

Choosing the correct size nipple shield can be confusing as nipples come in all different shapes and sizes. Your midwife or lactation consultant will ensure you are fitted with the correct size shield by measuring the diameter of your nipple. 

Once you’ve placed the nipple shield on, there should be a space between the end of your nipple and the end of the nipple shield. Your nipple should not be touching any sides of the shield. If your nipple touches the nipple shield, then the shield is too small. A nipple shield that is too small for you can cause further damage, be extremely uncomfortable and restrict milk flow leading to a reduction in milk supply. Inspect your nipple after every breastfeed to ensure your nipple is not misshaped, reddened or sore.

How to use a nipple shield

Knowing how to use a nipple shield properly will assist you to ensure your baby is well attached and breastfeeding efficiently. Nipple shields should not be used until your milk has ‘come in’ around day 3-4, enabling sufficient milk transfer through the shield and to your baby.

Simple steps on how to use a nipple shield:

1. Express a few drops of breastmilk onto the inside of the nipple shield

2. Stretch the base of the shield out and then place it over your nipple with your nipple in the centre of the shield

3. Position the cut-out section of the shield towards the top of your nipple or where baby’s nose will be, this way baby will be skin to skin with your breast

4. Hold the edges of the shield in place and encourage your baby to have a wide- open mouth and latch onto the whole shield and nipple

5. Once your baby is attached, ensure they are swallowing by identifying slight pauses mid suck and gulping or swallowing sounds

6. At the end of the breastfeed inspect your nipple, if it appears rubbed or chafed the nipple shield may be the wrong size for you

After using a nipple shield, it is important to clean it but it doesn’t need to be sterilised after every use (unless advised otherwise). Simply rinse the shield after breastfeeding and then wash in hot soapy water, rinse again with water, let it air dry and store in a clean airtight container.

Pros and cons of a nipple shield

The advantages of a nipple shield outlined with Children’s Health Queensland include:

• Helping a baby maintain a latch at the breast

• Minimal decrease in milk transfer

• Increased palatal stimulation to baby’s that need it to suck rhythmically.

Nipple shields also help increase the transfer of breastmilk to small or premature babies once they are attached. When used correctly, a nipple shield can be a total lifesaver if you want to continue breastfeeding but are having short-term struggles.

The disadvantages of using a nipple shield include:

• Breastfeeds may take longer as the shield does slow the flow of milk to some extent

• Some babies will become very familiar with the firm texture of the shield and find it difficult to transition back to attaching directly on your nipple without the shield.

• It can also decrease your milk supply with a lower transfer rate.

It’s important to ensure when using a nipple shield, that the baby shows adequate signs of hydration and continues to gain weight under the guidance of a professional.

Tips for using a nipple shield

• Expressing breastmilk into the tip of the shield (where the holes are) before l latching your baby will encourage them to attach and suck on the shield.

• Always use a larger size if you think the shield is too small for your nipple, this will encourage maximum milk transfer.

• Pointing the nipple shield at baby’s nose will encourage them to open their mouth wide and attach properly.

How to ensure you have a good latch

Even when using a nipple shield, it is important to ensure your baby has a good latch while breastfeeding. The following points are outlined by ABA to help you recognise if your baby is attached well:

1. Chin is pressed into your breast

2. Baby has a good mouthful of your breast

3. Their lips are flanged outwards and over the brim of the nipple shield. 

A good latch means that milk flow and supply won’t be impacted by the shield and helps your baby to develop good habits for if/when you stop using the shield.

Weaning your baby off using a nipple shield

After commencing use of a nipple shield, you should have a plan in consultation with your midwife or lactation consultant which includes recommendations for weaning baby off the shield, although you can use a nipple shield for as long as you or your baby need. Your baby can get used to breastfeeding with the shield and sometimes it can be challenging to breastfeed without it, so for this reason it is suggested to wean baby off the shield as early as possible, although it is not essential.

If you are wanting to try and wean your baby off the nipple shield, a few tips include:

• Skin-to-skin with your baby before breastfeeding

• Initiate a breastfeed without the shield when baby is showing early feeding cues

• Express breastmilk onto your nipple prior to the breastfeed

• Allow your baby to find their own way to your nipple

• Removing the nipple shield halfway through a breastfeed means your nipple is already drawn out, which makes it easier for baby to attach without the shield.

• Keep making attempts to attach your baby directly to the breast as much as possible so your baby gets used to feeding without the shield. If it doesn’t work, simply use the nipple shield and try again next breastfeed.

Remember every situation is different, consider advice from your midwife or lactation consultant and do whatever is best for you and your baby.

Shop nipple shields at Purebaby now.

Please note this blog is not medical advice and does not replace the need for guidance from your registered health professional. Blog is written by midwife Aliza Carr from Bumpnbub.