by Alissa Pemberton
BSc (Midwifery), International Board Certified Lactation Consultant & Holistic Sleep Coach
Every baby's journey with nipple shields will look a little different, but usually all of us will get to a point where we want or need to move away from using them and get our baby feeding directly from the breast. Nipple shields can play an important role, but it's always best to use them as a temporary measure and wean from them as early as possible, to make the process simpler for all involved and get your baby feeding more effectively at the breast. The most important thing to start with, is addressing the reason for using shields in the first place. Without correcting this your baby may find it very difficult to move away from them. If you used shields due to flat/inverted nipples...
In this situation you may find as your baby grows, gets stronger and more efficient at feeding - combined with a little help in the form of some breast shaping, that there's nothing to 'correct' when they transition from shields. Newborns sometimes struggle with flat or inverted nipples as there's no firm nipple to stimulate their palate and trigger them to start sucking. With an older baby who is used to breastfeeding, this can be less of a problem, but they'll probably benefit from shaping the breast as they begin the transition. Remember that it's breastfeeding, not nipple feeding, so with the correct shaping babies can feed even from mums with flat or inverted nipples. It's mostly the lack of stimulation against the palate that newborns struggle with in this situation. Check out our video here for a great technique to try.
If you used shields due to nipple pain, tongue tie, baby unable to latch etc...... In this situation you'll want to make sure you address this initial issue, as baby may struggle to move away from shields unless this is sorted. If shields were introduced due to painful feeding, baby slipping on and off the breast, make sure they've been assessed for tongue tie, and had any restriction managed or released as appropriate, that you've sought some support with improving their latch (see video link above!). The Weaning Process Weaning from nipple shields takes time, so be prepared to be persistent. The longer your baby has been using them, the longer it tends to take to wean from them. That's not to say it's impossible. I've done it myself with my first baby, who used shields for 3 months, and I've worked with many clients who have done the same. You might use a combination of these techniques throughout your journey, or find just one does the trick for you. Regardless be prepared it won't be a lineaer process. Baby might be able to feed on one side without a shield before they can feed on the other. They might manage some feeds without and still need the shield as a backup for other feeds, even for a matter of weeks afterwards. Techniques to Try No Pressure Feeding When you first start trying to remove the shield, try offering the breast outside of the time when you'd normally expect your baby to feed. Catching them in between feeds, or 30 minutes or so before a feed means they won't be frantically hungry. You can place them skin to skin, give them a chance to root around and self attach, and if they don't feed - neither you or baby will be stressed, it wasn't a 'proper' feed time anyway.
Most babies who transition from a shield, benefit from some help to shape and support the breast. The shield holds it's shape inside babies mouth, so they're using their tongue and jaw in a different way to what they would be directly on the breast.
By sandwiching the breast, tilting the nipple out and correctly positioning baby you can help make the breast an easier shape for baby to latch on to, more similar to what they're used to.
Check out my tutorial on the breast sandwich technique here
The Secret Slip Once baby is latched well on to the breast, let them feed for a few minutes (until they start to calm) then try quickly pulling the shield out, and then shaping the breast (see technique above) and latching them back on aga
in. As baby has already started to feed this will help to draw out your nipple or make it firmer, and easier for baby to latch on. If they fuss/get upset just put the s
hield back on and try again later. Try a maximum or 2-3 times per feed, before just letting them feed with the shield and try again. Pre Feed Pump This helps to achieve similar to above in that it firms and elongates your nipple, giving better stimulation to baby's palate when they latch on. Try using a good quality electric pump for a few minutes before latching baby on, or doing some manual nipple stimulation.
Distraction/Sleepy Feeds Especially with older babies, never underestimate the power of distraction or dream feeds. Changing location of feeds, feedin
g position, feeding standing up, moving around, in a carrier etc. can help to shake things up and let baby latch. Try safely cosleeping for a nap, with breast exposed and let baby latch just as they're stirring from, or falling asleep. Try offering a dream feed after baby has gone to bed, when they're drowsy and less away. You will probably want to combine this wit
h some breast shaping, and nipple stimulation to help make it easier for baby to deal with the change from the shield. Skin to Skin
Skin to skin is like natures reset button. It taps right back into baby's first feeding instincts after birth, and provides a calm situation for baby to begin to attempt feeding. I love combining this with no pressure feeding, and once a day hopping in the bath with your baby, placing them skin to skin. If baby shows interest in latching on, great. If not, don't worry. Just let them enjoy some positive time close to the breast, help guide them with some breast shaping, but don't be disheartened if it takes a few tries before they latch on. If you need support with any areas of your baby's feeding or sleep you can get in touch with Alissa Pemberton IBCLC & Holistic Sleep Coach here