Clinical use of silicone nipple shields.

Use of nipple shields is controversial. However, when weaning is imminent, they may enable breast-refusing infants to transfer back to the breast. A chart review of 248 clients seen during a 13-month period in a private lactation clinic revealed 32 women who received thin, silicone nipple shields. Among this group, the most common presenting problems were breast refusal (69 percent) and difficulty with latch (25 percent). Bottles had been introduced in 75 percent of these cases. Thirty-eight percent of the mothers using nipple shields weaned their infants during the initial crisis period; 56 percent continued to breastfeed for at least six weeks postpartum. Two ill infants continued to receive human milk by bottle for four and 12 months respectively. Parity appeared to correspond inversely with success of the shield intervention. The presence of flat or inverted nipples appeared to contribute to the phenomenon described as "nipple confusion."