A Lactation Consultant and a Nipple Shield to the Rescue!

A Lactation Consultant and a Nipple Shield to the Rescue!

April 25, 2018

A Brilliant ICU Nurse’s Breastfeeding Story

A Lactation Consultant and a Nipple Shield to the Rescue!

I have spent the last two days in Boston with my brother.  He had cardiac surgery and was brought directly from the operating room to his Intensive Care Unit room.  To say that the nurses who have been assigned to his care are extremely knowledgeable and confident would be a gross understatement.  

Yesterday, I had the pleasure of meeting Lana, the nurse who would manage my brother’s care for the next eight hours.  She kept his heart beating, his lungs aerated, his many IV lines calibrated and all tubes cleared and functioning. Lana monitored the machines that glowed numbers and sounded alarms and yet she never seemed at a loss for action and words. The consummate professional, she displayed the wisdom of education and experience.

When we got to talking, nurse-to-nurse, I mentioned that I was a board certified lactation consultant.  She immediately dropped her head down to her arms on the in-room computer control panel and moaned, “Oh my God, I couldn’t do it, I didn’t know anything!”  This brilliant woman, highly educated, able to keep human beings alive by extraordinary means...nearly gave up breastfeeding her newborn. I saw the tears in her eyes when she lifted her head. Lana went on to tell me her breastfeeding story, still passionate about all the details that caused her physical pain and emotional sorrow...5 years ago.  She received little to no breastfeeding support during her postpartum hospital stay. By the time an on-staff lactation consultant came to see her, the damage had been done. Raw nipples and severely engorged breasts made Lana cry each time she even thought about putting her baby near her nipples and the baby couldn’t latch on deeply enough because the breast tissue couldn’t be compressed.  When Lana suggested a nipple shield the LC said “Never!” Lana was discharged the next afternoon with no formulated care plan. This is her story. Where was the wisdom of education and experience for Lana?

Once home, Lana called her friend...the friend who had suggested the nipple shield. This wise friend also referred her to a pediatric practice with an LC on staff and invited her to the next meeting of her local mother’s group. In 24 hours she had an appointment with the lactation consultant and a nipple shield. Lana learned how to manually express her milk to soften the breast tissue behind the areola...

Lana learned how to fit a nipple shield correctly and how to position her newborn with his chin pointed to the most congested parts of her breast first for quick emptying and pain relief.  Lana and her baby had a successful feeding in the pediatrician’s office, the first in 4 days! The shield became unnecessary after 6 more days of continuing follow-up. She went on to breastfeed her son for 12 months and her second baby, a daughter, for 9 months – no shield needed.

Nipple shields can be great if you’ve already got painful nipples but remember, your breast tissue still needs to be compressible to achieve a deeper latch. Most babies will eagerly latch onto the prominent shield but a sore nipple is still gonna hurt if it’s now being pinched in the shield instead of free-floating, deep in the back of the baby’s mouth.  

Another concern is that the baby will refuse the breast without a nipple shield once he “gets used to it.”  I have found that most often, this is NOT the case. Occasionally I will have to ease the shield on and off over the course of a number of feedings to get the baby used to the feel of mom’s own nipple but well-supported babies nearly always take a properly offered breast with a ready milk supply.

This webpage will tell you most everything you need to know about nipple shields, including the need for guidance from an experienced breastfeeding educator to be sure your baby is getting enough milk.

Nipple shield use has been an issue in the clinical literature as some older studies discovered reduced breast milk transfer with their use, while more recent studies report successful breastfeeding outcomes, with normal breastfeeding baby growth rates.

Experience teaches us that there are many ways to face a challenge. Many paths can be taken by a breastfeeding mother.  A word from the wise:  You don’t have to accept “never!”

Paula Zindler
RN IBCLC



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