Weaning from a nipple shield

My friend just gave birth to her first baby and he had a poor suck. The nurses gave him bottles even though she very much wants to nurse. She used a breastpump for a week and now she is putting a bottle nipple on her breast to feed him. She wants to breastfeed. He has a good appetite and suck now. How can we wean him onto the breast? Is it too late?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Your friend has such wonderful support as she works to wean her baby back to the breast. I take it as a very good sign if her baby is happy when nursing, even if currently only feeding with the nipple shield in place.

However, nipple shields must be used with caution. Actual baby bottle nipples should never be used. They can seriously diminish a mother's milk supply. Depending on the amount of supplement your friend's baby is receiving, this could lead to slow weight gain, failure-to-thrive, or worse.

It is the top priority that your friend's baby be well-fed. A baby who is inadequately nourished not only has his health and well-being compromised, but he will not suck well at the breast. A baby under six weeks of age should be wetting six to eight diapers, and stooling at least twice each day. He should also be growing well -- gaining an average of four to eight ounces each week. If your friend's baby falls short in any of these areas, he needs to be seen by his Health Care Provider immediately. I would highly recommend working with a Lactation Consultant in your area to help bring the baby back to the breast, without compromising his health in any way.

Since your friend's baby is accustomed to nursing with a shield in place, I would recommend using a silicone shield instead of the bottle nipple. Changing over to this type of nipple shield will not cut the milk supply as drastically as the type of shield your friend has been using.

To wean from a nipple shield, many moms find it helpful to wear the shield as nursing begins. About two minutes into the feed, as the baby is relaxed and nursing well, remove the shield and slide the baby back onto the breast. Many babies will accept the breast. If not, finish the feed with the shield in place and try again the next time you nurse. Be patient. Her baby is used to the feel of the more firm nipple in his mouth, and now he must accustom himself to the feel of his mom's nipple. Do no cut away at a silicone shield, as is sometimes recommended. The silicone is sharp when cut, and could injure the baby.

I would never advise use of a nipple shield unless a mother is working along with a Lactation Consultant or Health Care Professional trained in their use, able to work along and follow the mom and baby closely, and able to properly assess the use of this intervention. Best of luck to you and your friend!

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