Should I use a nipple shield? When they might help (and when they don't)

The problem with 'whatever you do, don't use nipple shields'

I want to talk about something I keep hearing from new parents, and while I genuinely understand where it comes from, it bothers me.

'"Absolutely don't use nipple shields. Avoid them at all costs."

If you've heard this from a midwife or healthcare provider in those early days postpartum and felt like it sounded oversimplified - you're right. It is.

While this advice may be well-intentioned, when someone hasn't spent time understanding your unique situation, your story, or the nuanced pros and cons behind all available options, blanket statements like this can actually harm your breastfeeding journey.

A personal story that changed my perspective

One of my close friends credits nipple shields for saving her breastfeeding journey. Without them, she wouldn't have been able to continue nursing her baby. Yet when I was pregnant and asked about nipple shields at my antenatal breastfeeding course (they were literally displayed on the table in front of us), I was told not to worry about them because "they had no use."

No nuance. No 'well, in this particular scenario they might be useful.' Just a blanket dismissal.

Drowning in breastfeeding advice? Get my FREE video guide where I break down the five key basics you need to feel calm, confident and prepared from day one.

The real disadvantages of nipple shields (yes, they exist)

Let me be completely transparent: nipple shields do have disadvantages, and these are important to understand:

• Milk transfer issues: They can sometimes make it harder for baby to get milk effectively, and without proper lactation support, they may impact your milk supply

• Increased infection risk: They might slightly increase the risk of mastitis or blocked ducts

• Transition challenges: If you want to stop using them later, you might need extra professional support to wean off them

• Practical inconvenience: Honestly, they can be a bit of a hassle to use, clean, and remember to bring with you

These are real considerations, and I'm not dismissing them. Every parent deserves to know the full picture. Nipple shields wouldn't usually be my first go-to if I was supporting a parent - but I would also never completely disregard them.

When nipple shields can actually SAVE your breastfeeding journey

Here's what gets lost in the "absolutely don't" approach: there are legitimate scenarios where nipple shields can be genuinely helpful or even essential:

Valid reasons to use nipple shields

1. Premature babies: Nipple shields are often helpful with premature babies who need extra support to latch while they grow and gain the strength needed for effective breastfeeding.

   
   

2. Flat or inverted nipples: When nipple tissue isn't very stretchable, a shield can help baby achieve a better latch by providing something firmer to grasp onto

   
   

3. Persistent latching difficulties: Sometimes, even after proper lactation support and trying every technique, baby still struggles to latch - perhaps while you're waiting for a tongue tie assessment or some other specialist support - and a shield can bridge that critical gap

   
   

4. Bottle-to-breast transition: They can help babies who have been bottle feeding transition back to direct breastfeeding, as the shield feels more similar to what they're used to

   
   

5. Protecting damaged nipples: When you're experiencing severe nipple damage or pain, shields can provide relief while you heal and work on underlying latch issues

   
   

If you're in one of these situations - or one of the many other valid scenarios where nipple shields could be appropriate - the 'absolutely don't' narrative leaves you stuck. You're caught between ongoing damage, pain, a baby who isn't feeding effectively, and the fear that you're doing something 'wrong' if you try a shield.

How to transition off nipple shields (when you're ready)

If you've been using a nipple shield and want to wean your baby off it, there are a few strategies that can help:

Start gradually: Begin by offering your breast without the shield when baby is calm and not overly hungry. You can start a feed with the shield, then remove it mid-feed once baby is relaxed and milk is flowing.

Maximize skin-to-skin contact: Spend time holding baby skin-to-skin against your bare chest. This can trigger natural feeding instincts and make baby more willing to latch directly. Sometimes doing this in the bath can be extra effective.

Try different positions: Laid-back or biological feeding positions can help baby self-attach without the shield. Experiment with various holds to find what works.

Shape your breast: Use breast compression or a C-hold to make your breast shape more prominent, similar to how the shield extends outward. This can help baby latch more easily.

Choose optimal timing: Attempt shield removal when both you and baby are rested, patient, and in a good mood - not during stressful times like 3am feeds.

Be patient: Weaning from shields typically takes anywhere from a few days to several weeks. Some babies transition quickly, while others need more time. Both are completely normal. Take it one feed at a time, and if it doesn't work on one feed then go with the nipple shield for that feed and try again later.

Monitor feeding effectiveness: Watch for adequate wet nappies, weight gain, and signs that baby is getting enough milk. If you have concerns, work with an IBCLC who can create a personalised weaning plan.

Remember there's no deadline for stopping shield use. If your baby is gaining weight well and you're both comfortable, you can take your time with the transition - and if it;s working and you'd rather just keep using the shield, then that's a completely valid choice too.

Drowning in breastfeeding advice? Get my FREE video guide where I break down the five key basics you need to feel calm, confident and prepared from day one.

What proper breastfeeding support should actually feel like

You will literally never catch me saying 'absolutely don't' or 'you should just...'

Proper feeding support should feel like:

• Someone taking the time to understand YOUR unique situation - your baby, your body, your feeding goals, your challenges, your specific circumstances

• Having someone walk through the pros and cons WITH you, not AT you

• Getting help to weigh up whether potential downsides matter in your specific case, or whether the benefits might outweigh them right now

• Having options instead of rigid rules

• Having someone in your corner who can help you adjust the plan as things change and evolve, not someone who gave you one piece of advice and disappeared

Nuance matters in breastfeeding

There is so much nuance in breastfeeding support. Every single scenario is different.

What's right for one baby and parent might not be right for another. What works at two days postpartum might need to change by two weeks. Your circumstances, your baby's needs, and your goals all matter

This is exactly why you deserve support that sees YOU - not just a checklist of 'best practices.' You need someone who can support you to unpick the complexity of your situation and help you find what actually works for your family.

Finding the right balance

A lot of the time, nipple shields aren't the ultimate answer. But neither is struggling through severe damage, ongoing pain, or a baby who can't transfer milk effectively.

Sometimes shields buy you precious time. Sometimes they're temporary. Sometimes they're exactly what keeps breastfeeding going until you can get the full assessment or specialised support you need.

And often, after proper assessment and individualised support, they're not needed at all.

The key is having someone who can help you figure out which situation you're in.

Get personalised breastfeeding support

If any of this has resonated with you, I'd love to hear from you. You can check out my personalised breastfeeding support packages here. Or if you're local to Dorset or Hampshire and want someone to walk beside you in those early days and weeks, have a look at my postnatal doula offerings.

Katie x

Frequently asked questions about nipple shields

How do I know what size nipple shield I need?

Nipple shields come in different sizes (typically 16mm to 24mm diameter). The shield should fit comfortably over your nipple with a small space between your nipple tip and the shield's crown. Most people use a medium (21mm) size, but proper sizing depends on your nipple diameter. An IBCLC can help you find the right fit - using the wrong size can cause pain or reduce milk transfer.

Can I use nipple shields long-term?

While shields are generally recommended as a short-term tool, some parents do use them successfully for their entire breastfeeding journey. The priority is that your baby is feeding effectively and gaining weight appropriately. If both are happening, there's no absolute deadline to stop using them.

Will nipple shields decrease my milk supply?

Shields can potentially reduce milk transfer if not used correctly, which could impact supply over time. This is why it's important to work with a lactation consultant or breastfeeding counsellor, monitor your baby's output and weight gain, and consider pumping after feeds in the early weeks to maintain supply. However, many parents successfully maintain their supply while using shields with proper support.

How do I clean and store nipple shields?

Wash shields with hot soapy water after each use, and store them in a clean, dry container. It's helpful to have 2-3 shields so you always have clean ones available. Keep one in your nappy bag so you're never caught without it when feeding away from home.

Katie Small | Rewrite your Postpartum

Doula and Breastfeeding support in Dorset, Hampshire and online