Nipple Shield

What is a nipple shield?

A nipple shield is a silicone device that fits over your nipple to help your baby if they struggle with breastfeeding. Nipple shields have a base that wraps around your areola (skin around your nipple) with a cone-shaped area for your nipple. Some nipple shields have an area cut out to allow more skin-to-skin contact between you and your baby. The nipple part of the shield has tiny holes at the tip that allow milk to flow into your baby’s mouth. Most nipple shields are thin, flexible and transparent.

Should I use a nipple shield?

Nipple shields are a temporary solution for some people, but they shouldn’t be your go-to when you encounter a breastfeeding issue. In most cases, a nipple shield won’t address the underlying cause.

Before you try using a nipple shield, talk to a lactation support provider like a lactation consultant or a breastfeeding medicine specialist. Your provider will identify the cause of any breastfeeding difficulties you’re experiencing. They’ll also recommend solutions, which may include short-term use of a nipple shield.

If your provider recommends you use a nipple shield, they’ll come up with a plan to wean your baby from using the shield. It’s important to have this plan from the start. Your provider will also monitor your baby’s weight to make sure they’re getting the nutrition they need.

What does a nipple shield help with?

A nipple shield might help with your baby’s ability to latch. Your baby’s latch refers to how their mouth attaches to your nipple and areola during breastfeeding. A good latch helps your baby empty the breast and get enough milk during feedings. An improper latch is a common cause of breastfeeding pain. This is because your baby is sucking just the tip of your nipple instead of taking the entire areola part of the breast into their mouth.

A nipple shield may be a helpful short-term solution when:

• You have short, flat or inverted nipples. A nipple shield helps by making your nipple longer and harder. Keep in mind that you might think you have flat nipples when, really, your breasts are just engorged. Managing engorgement through reverse pressure softening (applying gentle, steady pressure in the area around your areola) can help your nipple stick out better for nursing. A lactation support provider can show you how to do this.
• Your baby needs more stimuli to begin sucking. A more extended nipple can help touch the roof of your baby’s mouth, which stimulates their sucking reflex.
• Your nipples are sore, cracked or bleeding from a poor latch. Wearing a shield could help your nipples heal. But your provider will still want to find the cause of the poor latch and address it directly. 
• You’re transitioning your baby from a bottle to breastfeeding. Sometimes, babies struggle with this transition due to the change in flow. They may be used to a fast flow from the bottle and get frustrated at the breast when the flow is slower. But other times, it’s a matter of texture. They may be used to the texture of a bottle nipple and need some time to adjust to the feel of a natural nipple. Using a nipple shield can help with this transition.

Speak with your lactation support provider before using a nipple shield. They’ll ask to observe your baby’s latch and nursing position. Sometimes, minor adjustments can help your baby latch better without ever needing to use a nipple shield.

Nipple shields typically aren’t an effective solution for:

• Improving latch in babies born prematurely or babies who have tongue-tie (ankyloglossia).
• Managing breastfeeding when you have low milk supply or mastitis.

How does a nipple shield work?

A nipple shield is like a second nipple. It goes over your areola and nipple and has tiny holes at the end where milk can transfer from your nipple to your baby’s mouth. It helps infants with trouble latching onto the breast by acting like a longer, firmer nipple. This makes it easier for your baby to learn how to latch and suck. You should stop using a nipple shield once your baby can nurse from your nipple directly.

Nipple shield sizes

Nipple shields come in different sizes, measured in millimeters. The size that’s right for you will depend on the size of your nipple. Your nipple should fit comfortably inside the conical shape of the nipple shield without touching the sides.

If you’re unsure what size you need, talk to your lactation support provider. They’ll guide you in selecting the size that’s right for you.

How do you put a nipple shield on?

It’s important to have a nipple shield in the right size and apply it correctly. Using a nipple shield incorrectly will lead to more problems with breastfeeding or prevent milk from flowing from your breast to your baby.

Steps for putting on a nipple shield

Turning the nipple shield inside out before applying helps draw your nipple into the cone-shaped area of the shield. Here’s what to do:

1. Place your thumbs on the base of the shield.
2. Flip the shield halfway inside out. That’ll leave a small dimple at the end.
3. Put your nipple into that dimple. Then, stretch the silicone base of the nipple shield down over your areola.
4. Apply nipple cream or water around the edge of the nipple shield to help it stick.

The base should feel snug around your areola. Your nipple should be deep into the cone-shaped area without touching against the sides.

Your nipple shield will come with instructions you can follow. A lactation support provider can give you further guidance and show you how to apply the shield.

How should my baby latch onto the nipple shield?

When your baby is latched correctly to the nipple shield, their mouth should be over the whole nipple with their lips extended around the areola. Your baby shouldn’t be sucking on just the tip of the nipple.

How do I know the nipple shield is working?

It’s likely working if your baby seems full or satisfied after a feeding and you hear your baby swallowing while nursing. You can also monitor how much milk they get by weighing them on a healthcare provider’s scale or counting how many wet diapers they have each day. Your baby should have at least six wet diapers per day.

What are the risks of using a nipple shield?

Lactation support providers typically don’t recommend a nipple shield unless it’s absolutely necessary. Some of the disadvantages of using a nipple shield are:

• It’s difficult to wean a baby from a nipple shield. They may become too dependent on it.
• Using a nipple shield limits skin-to-skin contact between you and your baby.
• Your baby may not transfer as much milk through a nipple shield as they would directly from your nipple. This may lead to slow weight gain in your baby or low milk supply.

If you’re using a nipple shield, your provider may recommend pumping after nursing. This can help empty your breasts and stimulate more milk production.

What are the advantages of using a nipple shield?

The drawbacks of using a nipple shield often outweigh the benefits. But in certain situations, a nipple shield may:

• Give your baby extra time to learn to nurse or improve their ability to suck.
• Allow a damaged nipple to heal while you work on improving your baby’s latch.
• Allow you to continue breastfeeding and avoid switching to formula.

Does a nipple shield help with pain?

Yes, a nipple shield can help with cracked, sore or bleeding nipples. A bad latch causes painful nipples. If your baby continues to latch poorly to a nipple shield, you may still feel pain even while wearing one or when trying to wean from one. Getting your baby to latch correctly is the first step in relieving nipple pain. Once this happens, you should be able to breastfeed without pain.

How do I wean my baby from a nipple shield?

A nipple shield is a short-term solution. Your lactation support provider will develop a plan to wean your baby from using it. Weaning means your baby starts nursing directly from your breast rather than through a nipple shield. Your provider will tailor advice to your specific needs. Here are some general tips:

• Try weaning at times when your baby feeds the best.
• Pump until your milk “lets down,” then breastfeed.
• Go to a quiet, comfortable area without distractions.
• Offer lots of skin-to-skin contact without the nipple shield (to see if your baby latches).
• Gradually remove the shield partway through nursing or when you switch breasts.
• Breastfeed frequently and before your baby is too hungry. Hungry babies tend to be fussier.
• Try to remove the nipple shield when your baby is sleepy or almost asleep.

How long can I use a nipple shield?

You should use a nipple shield for the least amount of time possible. Your lactation support provider will develop a weaning plan from day one. The longer you use a nipple shield, the harder it’ll be to stop using it. It can also disrupt your milk supply. Your provider can help you with the weaning process to make this easier for both you and your baby.

When should I contact a healthcare provider?

Lactation support providers can identify and solve a wide range of breastfeeding issues. Reach out to a provider if:

• You have pain while nursing.
• Your nipples are cracked, sore or bleeding from nursing.
• Your baby seems overly fussy or refuses to latch on.
• Your baby has a shallow latch (nipple only) or otherwise struggles with latching.
• You have questions or concerns about using a nipple shield or weaning your baby from it.

Always talk to a lactation support provider before using a nipple shield. They’ll tell you if it’s necessary and help you use it properly. They’ll also closely follow your progress and make sure you wean at the appropriate time.

Contact a pediatrician if your baby has fewer than six wet diapers in a day. This may be a sign of dehydration from not taking in enough breast milk or other causes. Your pediatrician will identify the cause and make sure your baby gets the fluids and nutrients they need.

Where can I get a nipple shield?

You can get a nipple shield:

• At retail stores or pharmacies.
• Through your healthcare provider or lactation support provider.
• At the hospital after you give birth.

But proceed with caution. Just because it’s easy to get a nipple shield doesn’t mean you should use one. Only use a nipple shield if your provider recommends it and gives you a plan for its use.

How do I clean my nipple shield?

Sterilize your nipple shield before its first use by placing it in boiling water for 15 minutes. You should wash your nipple shield with hot water and soap after each use. You can also put it on the top rack of a dishwasher on a hot cycle. Make sure it’s completely dry before using it again.