The Ultimate Guide To Nipple Shields (When & How to Use Them Correctly)

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Is baby having trouble latching? Are your nipples sore? Did someone suggest a nipple shield? Before you use one, here is everything you need to know about how to use nipple shields properly, including red flags to be aware of and types of nipple shields to avoid.

Many breastfeeding parents are given a nipple shield early on in their breastfeeding journey. It happens like this: A nursing parent is experiencing nipple pain or struggling to latch baby, and a well-meaning labor and delivery nurse, lactation consultant, or midwife hands the parent a nipple shield. It happens all the time. It even happened to me!

While nipple shields seem like a clever solution to breastfeeding woes, it’s best to not think of them that way. That’s NOT to say that nipple shields are bad or shouldn’t be used! On the contrary: Nipple shields are simply a tool in our feeding tool belt. Let’s talk about this tool and how to use it.

What They Don't Tell You About Breastfeeding

This is what they don’t tell you in the hospital. Our FREE guide will give you 12 breastfeeding secrets that will help you avoid common problems down the road. 

The Ultimate Guide to Nipple Shields: Tips from a lactation consultant IBCLC

What Is a Nipple Shield?

A nipple shield is a piece of thin, flexible, nipple-shaped silicone that is affixed to the breast before feeding. Holes on one end allow milk to pass through while the shield provides a barrier between the baby’s mouth and the breastfeeding parent’s nipple.

(Please note that this post is not about breast shields, which are a very different product! You can learn more about breast shield sizing here.)

What Parents Need To Know About NIpple Shields

Nipple shields are often considered breastfeeding “must haves.” But the truth is, most breastfeeding parents won’t need a nipple shield. In fact:

Needing to use a nipple shield can be a red flag.

Again, that DOES NOT mean that nipple shields are bad to use or will cause you problems! It just means that if you need one, something is going on–whatever is prompting you to reach for a shield–that should be investigated.

For example, if you’re using a nipple shield to help cope with nipple pain, I’d want to get to the bottom of what caused that pain to begin with. If you are using a nipple shield because baby can’t latch without one, I’d want to get to the bottom of why baby needs a shield to latch.

Breastfeeding mother holding a nipple shield

Nipple shield use is usually only temporary: Perhaps whatever prompted you to pick up a shield goes away on its own or is something that you were able to take steps to resolve in a short amount of time. In which case, yay! That’s great to hear!

However, if you find yourself dependent on a nipple shield or unable to easily wean from it, you may benefit from lactation support. While some parents are able to use nipple shields long term without issue, many parents find long-term shield use cumbersome. Furthermore, sometimes shield use masks underlying feeding issues that can eventually get worse over time. So it’s most often best to seek lactation care as soon as possible if you find yourself needing to use a shield (you can learn how to find qualified lactation care in your area here).

When Should You Use A Nipple Shield?

Nipple shields can be helpful in certain situations. For example:

  • If you have flat or inverted nipples
  • If baby was born prematurely and needs assistance latching or additional stimulus to prompt sucking
  • If baby has a weak suck
  • If there is an issue with baby’s mouth or tongue that affects their latch (i.e. if you are able to maintain a better latch with a shield compared to without one)
  • If you’d like to keep baby feeding at the breast, rather than bottle feed, while you sort out feeding issues
  • If you’re transitioning baby from bottle to breastfeeding
  • If you need temporary relief from early nipple pain to allow for healing

In these situations, using a nipple shield can:

  • Give baby the opportunity to learn how to breastfeed
  • Help premature babies take in more milk at the breast
  • Avoid or reduce the need to pump milk or use bottles
  • Eliminate or reduce time spent cleaning/sterilizing bottles and pump parts

However, there are caveats!

  • Difficulties with latching, sucking, or tongue mobility are sometimes signs of underlying oral issues that can affect feeding and milk supply. Nipple shields will not fix these issues, which can persist or worsen over time. Fortunately, these things can be treated by a qualified lactation professional (most pediatricians do not provide the kind of lactation care these babies need). The sooner you can get help, the better!
  • Sometimes nipple shields rub against damaged nipples and don’t offer much pain relief. They are not designed to be a solution for nipple pain. You will likely be better off treating nipple pain by trying the techniques described in this post.
  • Some lactation consultants recommend additional pumping to protect your milk supply while you use a nipple shield. Consult an IBCLC for more guidance.

Do Nipple Shields Lower Milk Supply?

The belief that nipple shields cause low milk supply most likely comes from outdated research on old-fashioned nipple shields. These older shields were essentially thick, rubber bottle teats set on top of the nipple and looked something like this:

Old-fashioned nipple shield
Image Credit: Glass Nipple Shield. Wellcome Collection.

These old-fashioned nipple shields positioned baby’s mouth relatively far away from the nipple and didn’t allow for much nipple stimulation. This is not good, since nipple stimulation is necessary to trigger a series of hormonal messages needed to breastfeed. These hormonal messages tell the breastfeeding parent’s body to release milk and make more milk. So if these messages are not sent effectively, milk supply can be affected over time.

The milk ejection reflex
The Milk Ejection Reflex is triggered by nipple stimulation at the breast.

Modern nipple shields, in contrast, are very thin and allow for a lot more nipple stimulation. When applied correctly, they pull a good amount of breast tissue into baby’s mouth–not just the nipple or a portion of it.

Important Note: If a baby needs a nipple shield to nurse comfortably, it is possible that there is an underlying breastfeeding problem going on. The underlying problem itself may lead to low milk supply more so than the nipple shield. Because of this, it may be recommended to do additional pumping to maintain milk supply when using a nipple shield. Consult an IBCLC for guidance.

What Type of Nipple Shield Should You Use?

Since nipple/breast stimulation is so important, I recommend nipple shields that look like this…

Recommended nipple shield shapes
Some shields come with a cutout so baby’s nose can be in contact with the breastfeeding parent’s skin.

…and I DO NOT recommend nipple shields that look like this:

Nipple shield shapes not recommended
These shields are made of a thicker silicone and are generally not recommended by lactation professionals.

This style nipple shield looks eerily similar to the old-fashioned nipple shields that were strongly associated with milk supply issues. They are made of a much thicker material, and babies tend to pull much less breast tissue into their mouths when using them.

Baby latched with a modern/standard nipple shield
Baby latching with a modern silicone nipple shield. This baby has comparatively more breast tissue in his mouth.
Baby latching with a nipple shield resembling the old-fashioned style (Image credit: @sharneeninjaa) 

This old-style nipple shield could be especially problematic if you have flat or small-diameter nipples. In my opinion, it’s best to avoid this style shield altogether unless otherwise advised by an IBCLC familiar with your situation.

How To Put On A Nipple Shield (The Right Way)

Since getting a good amount of breast tissue into baby’s mouth is so important, let’s talk about how to put on a nipple shield in a way that allows us to do this. You don’t just set the shield on top of your nipple!

To properly apply a nipple shield to the breast, begin by getting it wet and shaking it dry (don’t towel dry it–this will keep lint off the silicone, keeping it nice and grippy).

Next, invert the nipple shield a bit and stretch the open end of the shield. While keeping the shield stretched like this, place the shield on top of the nipple like a little hat:

How to apply a nipple shield to the breast the right way
It’s okay if your shield is still a little wet–you just don’t want it dripping. A good shake is all you need to dry it sufficiently.

When you release the nipple shield, as much of the areola as possible should be pulled into the shield. You can see this technique in action in the video below:

Make sure that the nipple is centered in the shield. If you’re using a nipple shield with a cutout on one side (such as the Medela Contact Nipple Shield), make sure the cutout is positioned on your breast where baby’s nose will be once baby is latched. If your shield needs adjusting, remove it and reapply as needed using the technique described above.

Latching With A Nipple Shield

To latch baby using a nipple shield, you’re going to use the same latching techniques you would use to latch baby without a shield. Likewise, when evaluating baby’s latch with a shield, you’ll be looking for the same signs of a good latch without a shield:

  • Wide open mouth
  • Lips flanged or neutral, not rolled in
  • Baby’s head not tucked into his or her chest
  • Painless feeding
  • Good milk transfer/weight gain/diaper output

If you feel a sharp pinch while feeding, the nipple shield may not be centered over the nipple, or the shield may be too small.

Baby latched on with a nipple shield
Here is a baby latched on to a nipple shield pretty well. I might adjust baby’s body so the chin touches the breast, but otherwise, this looks pretty good!

Making Sure Everything Is Working…

  • When your milk has increased in volume (“come in”), you should see and hear baby swallowing
  • You should see a little milk sitting in the nipple shield
  • Breastfeeding should not be painful (assuming nipples weren’t already sore to begin with)
  • Your breasts should feel softer after feeding
  • Baby should seem satisfied after feeding
  • Baby should be stooling and voiding an appropriate amount and an appropriate number of times per day

Cleaning And Storing Your Nipple Shield

When your nipple shield is brand new, you’ll need to wash it with hot, soapy water and sanitize it before first use (you can learn more about sanitization methods in this post). After that, if baby is full-term and healthy, washing your shield in hot, soapy water after each use is sufficient. However, if baby is premature or medically fragile, wash your shield in hot, soapy water AND sanitize it after each use. Allow your shield to dry (a good shake and air dry is sufficient) and store it in a clean, airtight container.

How To Wean From The Nipple Shield

There is no set time at which you must wean from a nipple shield. You may find you use one for a few days, a few weeks, or a few months. The weaning process may be very quick, or it may take time (it took my baby 1 month to fully wean from a nipple shield). Here are some tips for weaning from a nipple shield:

  • Attempt it when both you and baby are in a good mood and when you have time to be patient
  • Attempt it before baby gets very hungry, at the first sign of feeding cues (stirring, mouth smacking, rooting)
  • Spend lots of time skin-to-skin with baby (some babies will find the nipple and latch on their own)
  • Try nursing with the shield for a bit first, then removing the shield and re-latching baby
  • Don’t force the issue: Stop the attempt before you and baby get too frustrated and try again later

When To Seek More Help…

Any time you feel you need to use a nipple shield, it may be a good idea to seek breastfeeding help. This help may come in the form of a free breastfeeding support group, an in-person (usually free) support meeting with a peer counselor, or professional lactation care (most pediatricians do not provide the kind of lactation care breastfeeding parents need).

READ MORE: How To Find A Lactation Consultant Who Supports You

However, there are some nipple-shield-specific circumstances in which I would ESPECIALLY recommend getting help from an IBCLC/lactation consultant. These include:

  • If baby is not having appropriate diaper output, is not gaining weight well, or gains weight well at first but starts to gain slower around 2-4 months old
  • When breastfeeding pain lasts longer than 1-2 weeks OR if pain is severe after just a couple of days
  • If you are not able to get a comfortable latch without using a nipple shield
  • If you are having milk supply issues
  • If you are having trouble weaning from the nipple shield

What They Don't Tell You About Breastfeeding

This is what they don’t tell you in the hospital. Our FREE guide will give you 12 breastfeeding secrets that will help you avoid common problems down the road. 

If you enjoyed this post, be sure to check out our digital library of helpful resources that quickly teach how to avoid common breastfeeding problems and give you the peace of mind and confidence you need to meet your breastfeeding goals.

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