Should I use a nipple shield?

Should I use a nipple shield?

A nipple shield is a silicone contraption that looks like a nipple, and you place it on the nipple and areolar area of your breast. It protects and shapes your nipples, making it easier for your baby to get a good latch.

Nipple shields get a bad rap in the breastfeeding community, but they can be a lifesaver—for breastfeeding moms and for their babies. 

That said, they shouldn’t be your first line of defense. A shield often covers up an underlying problem, and if you solve the problem, you won’t need the shield. But if you truly do need it, don’t feel one bit bad about using it. If it makes breastfeeding work, then it’s worth using.

Ask a board-certified lactation consultant (IBCLC) to help you use the shield correctly. Use Maade’s exhaustive lactation consultant database to find a wonderful lactation consultant near you.

How nipple shields work

When the baby doesn’t get a good latch, it can hurt the mom’s nipples and hinder the baby’s ability to get milk. The nipple shield solves this problem in three ways:

  1. The shield helps the baby get a good latch, because the nipple is protruding in a way that makes it easy to grab onto.
  2. The shield protects your nipples while your baby is learning how to latch. That process can seriously hurt! 
  3. The shield improves the baby’s sucking. Its firm tip stimulates the roof of your baby’s mouth to trigger the sucking reflex. Sometimes, if your baby doesn’t get a good latch or the nipple isn’t poking out far enough, then it doesn’t tickle the baby’s mouth, and then the baby doesn’t get the signal to start sucking firmly.

These are three powerful accomplishments. Nipple shields can work wonders if you need them.

Nipple shields don’t automatically decrease milk intake

Some resources say you need to watch your baby for slow weight gain and regularly count his diapers, because nipple shields decrease milk transfer. Other resources disagree.

To be safe, weigh your baby at least every two weeks, and always use the same scale. (Any small discrepancies could seem like a big deal when you’re measuring in ounces.) If you’re not sure whether your baby is on track for weight gain, ask your pediatrician.

Your baby should fill at least 2 dirty diapers and at least 6 wet diapers every day (24 hours), unless he’s younger than 6 days, in which case he might not reach 6 wet diapers. Look for a light yellow color to demonstrate that he’s not dehydrated.

However, if you use a thin silicone shield, you might not be in any danger of reducing milk transfer. A study of 50+ moms compared babies using nipple shields with babies taking the bare breast, and it found no difference in weight gain over the first two months.

(An older study from the 80s found the opposite – but back then, moms were using thick rubber shields. Those hard shields made it a lot harder for the baby to get a good suck and draw out all the milk.)

Of course, even if you use a silicone shield, you should still track your baby’s weight gain and diapers. Those are crucial ways to track your baby’s health in general. But you shouldn’t worry unnecessarily just because you’re using a nipple shield. (If you do notice a decrease in diapers or weight gain, contact your pediatrician or healthcare professional.)


Good reasons to use a nipple shield

You have a preterm infant. Premature babies often have trouble breastfeeding, and nipple shields make it easier for them. The shield positions the nipple for optimal feeding, even if the baby isn’t strong enough to suck it in sufficiently. And it keeps the nipple in that position, even if baby takes a lot of breaks.

Whatever helps your baby get enough breastmilk is a good thing, especially if that baby is medically vulnerable. Although shields should usually be used for a short amount of time, you may need it longer if you have a preemie.

You have flat nipples or inverted nipples. A shield isn’t the only way to address inverted or flat nipples, but it does help.

Baby has latching issues, and other methods aren’t helping. Shields make latching easier. There are a lot of other things you can try first (see below), but shields are a great back-up option.

Baby is struggling to learn how to breastfeed. This usually takes the form of a bad latch, but it bears repeating. Some babies get the hang of latching right away. Others truly struggle. Shields make it easier, and if that’s what it takes to get your baby to nurse, then it’s a great option.

You have sore nipples (or chafed, bloody, blistered, or cracked nipples). The shield can help protect your nipples while they heal. Also try lanolin nipple cream or nipple butter - it works wonders for healing irritated skin. Lansinoh nipple cream is well known to be effective. 

Baby has a tongue tie or lip tie. This is another thing that can make breastfeeding more difficult, and a shield can help. But ties can create long-lasting difficulties in breastfeeding, so it’s super important that you see your pediatrician for a follow-up appointment to deal with the tie. This is especially true if you want to wean your baby off the shield eventually.


Benefits of using a nipple shield

It makes breastfeeding easier. Because it gives the nipple a more defined shape, it makes it easier for the baby to latch on properly. Getting a proper latch is one of the most difficult tasks in breastfeeding. Pop on a shield and there you go, it’s much easier. Some babies even learn proper latching from using a shield, in which case it makes itself obsolete.

It protects your nipples. If you have consistent nipple pain, then the shield can provide a level of temporary protection. 

No one wants to be in constant pain for months, especially in such a sensitive area, so you might be tempted to switch to formula. If you feel like giving up but you also want to keep going, try a nipple shield first. Even if it’s a temporary fix, it may give you the relief you absolutely need. (No shade if you do want to switch to formula—but if you’re on the fence, try a shield first.)

However, if your nipples are consistently in pain, then there’s definitely an underlying problem causing that irritation—probably a poor latch. Contact a lactation consultant to help you solve it, and then you won’t need the shield.

It can help you stick with breastfeeding. If your baby is having trouble eating and consequently struggling to gain weight or fill diapers, or if you’re in so much pain you’re thinking about quitting, then consider using a nipple shield first.

woman breastfeeding


Downsides of using a nipple shield

Less milk transfer. I know, we just said it doesn’t inhibit milk transfer—but that’s when it’s used correctly. If you use it the wrong way, then it can prevent the baby from getting a full meal. This is another reason why it’s crucial to work with an IBCLC certified lactation consultant.

Greater risk of clogged ducts and mastitis.  This is also a byproduct of incorrect usage. If your baby isn’t removing enough milk, that means too much is left in your breasts. Too much milk production could clog your ducts, which can lead to mastitis.

It can damage your nipples. Even though the shield is often used to prevent or fix damage, it can actually cause damage if it’s used incorrectly. Again, ask your lactation consultant for feedback.

Less skin-to-skin contact. Your baby’s chin and nose should touch your breast, but in this case, they will actually touch the shield. Skin-to-skin provides sensory signals for you (triggering let-down) and for your baby (it even regulates his heart rhythms!).

It’s difficult to stop using it. Ideally, the nipple shield should be a temporary fix. But it’s hard to wean off of it. (See below for weaning suggestions.)


How to use a nipple shield correctly

Use a thin, clear silicone nipple shield. These are best for making sure your baby gets enough milk. They’re also easier to wean off of, because they’re more similar to mom’s breast.

Some shields have a cutout portion (that doesn’t reach the nipple) so you and baby have more skin-to-skin contact. However, these shields may not stay in place as well.

Do NOT use a baby bottle nipple. It won’t work properly and it teaches a poor latch.

Use the right size shield. Here’s where a lactation consultant can help you. She knows how to fit a shield to find the perfect size for you and your baby. You might need two different sizes, one for each boob.

Make sure your baby is latching deeply. Here are some good signs of a strong latch:

  • Listen and watch for a regular pattern of deep swallowing while you breastfeed.
  • Make sure your baby has most or all of your areola in his mouth.
  • The baby’s sucking movements don’t hurt your nipple.
  • The shield doesn’t look puckered or warped.
  • You feel your milk let down. (It’s not a requirement—some women never feel it—but it’s a good sign if you do.)
  • There’s a bit of milk left in the shield when the baby is done drinking.
  • Your baby seems satisfied after eating—he’s calmer, his muscles are relaxed, and he’s not fussing as much.

Feel for softer breasts after breastfeeding. This is another good sign that the baby had a full meal. It also reduces your risk of plugged ducts and mastitis. Fully draining your breasts helps you maintain your milk supply because your body knows how much your baby really needs.

Stretch the shield almost inside out, then smooth it onto your nipple (right-side out). This helps draw your nipple into the shield. The shield should be nestled snugly against your breast. Moisten the edges with water to keep it suctioned on. 

You may have to try applying it a few times and experiment to discover what works for you and your boobs. Give it a whirl before you bring the baby into the mix, so that he doesn’t have to wait impatiently.

Contact a lactation consultant (IBCLC) for individualized support. Not only can she give you peace of mind, but she can also correct your nipple shield usage just in case you’re doing something wrong. She may even be able to help you avoid the shield altogether.


Things to try before using a nipple shield

Prepare your nipples before breastfeeding. Tug on them, roll them, even try putting ice on your nipples to harden them. Another good trick is using a breast pump, because it elongates your nipples. Anything that makes it easier for the baby to latch onto them.

Squish your breast like it’s a sandwich. Yep, a nice snack for baby. Squish from top to bottom–fingers on the bottom, thumb on top—to make your nipple protrude farther and feel firmer. This also helps facilitate the baby’s latch.

Get a good latch. Make sure your baby faces you and doesn’t crane his neck. Wait until he opens his mouth very wide, then go for the latch—pull him close to you so that as much of your breast as possible goes into his mouth. Your breast should be so close that baby's nose and chin both touch it.

Make sure his lips are curling out, not caught up between his face and your breast. Gently flip them out if you need to. This is a crucial part of getting a good latch, because it creates a strong seal and positions the sucking muscles correctly.

Pump for a few minutes first. Not only does this help with nipple shape, but it also stimulates let-down so that the milk flows. If your baby gets milk immediately, he may be more patient.

Breastfeed often. If your baby has lots of chances to learn, he’ll catch on quicker. And if you catch him before he gets hangry, then he’ll be more patient with the learning process. Even try it when he’s half asleep.

Get comfortable. Try different breastfeeding positions until you find one where you and your baby are both totally comfortable. This helps you both relax and connect.

Nurse skin-to-skin. Remove your baby’s clothes and your shirt (cover up with a blanket if it’s cold—not over the baby’s face of course). This also helps you both relax, and it stimulates the baby’s natural response to you. You could even try breastfeeding in a nice warm bath.

skin-to-skin breastfeeding


Be patient and encourage patience. If either of you gets upset, take a short break. If breastfeeding becomes a bad experience, then the baby is less likely to get the hang of it, and you’re less likely to stick with it.

Ask a lactation consultant for help. But if you still get routinely frustrated, it might be time for a nipple shield.


How to wean off the nipple shield

Honestly, it’s up to you whether you wean off it at all. Technically the shield is intended as a short-term problem-solver, but if it’s working for you and baby, there’s no strong reason to stop using it. If you want to wean off, though, here are some tips.

Try all the things in the previous section. Those tips help with weaning off a shield as well as avoiding one in the first place. They’re just focused on establishing natural breastfeeding.

Catch your baby at her best. Does she feed most calmly in the morning? Make that the first feeding you wean off the shield.

Simply offer your bare breast. It’s totally possible that your baby has figured it out by now and will be able to drink from your breast directly. It won’t happen immediately, but keep giving opportunities.

This is often easiest when the baby is sleepy and she’s too lazy to question what’s going on.

Remove the shield mid-feeding. This way baby is having a good experience, she’s feeling settled, and she knows that nursing gives her milk. Gently unlatch her, remove the shield, and latch her back on.

Offer the second breast without the shield. Similar to the mid-feeding advice, just use the shield on the first breast, and don’t switch it to the second breast.

Do NOT cut away the tip of the nipple shield. This leaves sharp edges that can cut your baby’s mouth (and that’s not going to make her like breastfeeding more!).

Be patient with yourself and your baby. We already said this, but we’ll say it again. Patience and gentleness are key. The shield-weaning process shouldn’t sap your joy in the breastfeeding experience. If it takes a few weeks, that’s no problem. If you decide to keep using the shield, that isn’t a problem either.


Top 4 nipple shields on the market

  1. Lansinoh Contact Nipple Shields (with Case)

These nipple shields are designed to help your baby get a better latch. They’re “ultra-thin, super-soft, flexible 100% silicone.” They also have a cutout at the top to increase skin-to-skin contact, stimulating both you and the baby and promoting bonding. The Lansinoh shields come in two sizes, 20mm and 24mm. Just don’t wash them in the dishwasher (hand-washing or boiling is fine).

  1. Medela Contact Nipple Shields and Case

Medela created this product to protect the breastfeeding bond. If nursing is going poorly or hurting, you’re less likely to feel successful—and less likely to keep nursing. Medela knows that the shield can save the day during that difficult adjustment period where your baby is learning to latch and your nipples are healing. These nipple shields come in 20mm and 24mm, like Lansinoh, but they also have a smaller 16mm size. 

  1. MAM Baby Nipple Shields

Intended for short-term support, these nipple shields are designed to be extremely similar to breasts. They’re made of a trademarked type of very thin silicone, SkinSoft Silicone, that mimics the feel of skin. The sides have small holes for better aeration, which is especially helpful when you’re sweaty. They also have a unique shape, almost like a pacifier—it flanges out on both sides but is short on top and bottom. This maximizes skin-to-skin contact more than standard nipple shields. The MAM shields also come in a box you can use for sterilization.

  1. Haakaa Silicone Breastfeeding Nipple Shield, Butterfly Shape

Unlike other shields, the Haakaa shield has an extra-long nipple so that there’s more space between the baby’s mouth and your poor sore nipple. Whether your nipples are cracked or your infant bites, these shields will provide extra protection. The sides also have strong suction—no matter what breast shape you have—and an anti-slip ridged outer edge, creating “a hands-free breastfeeding experience.” The variable flow nipple even helps prevent colic. 


Don’t forget, find a lactation consultant

Lactation consultants are useful for standard breastfeeding, but they’re crucial whenever you’re doing something different or extra. Protect your nipples and your baby’s health by getting feedback on whether you’re using the shield correctly.

If you’re struggling with breastfeeding but you want to continue, and the shield helps you keep at it, then hooray!