A shield can be a lifeline or a hindrance, and in my experience the difference is nearly always whether someone helped set it up. A nipple shield is a thin, flexible silicone cover that fits over your nipple during a feed, with small holes at the tip for milk to pass through. Used at the right time and in the right way, it can be a real help. Used without support it can sometimes cause problems, so this guide explains when it helps and how to use one well.

What a nipple shield is

A nipple shield sits over your nipple and areola while your baby feeds, so your baby latches onto the shield rather than directly onto your breast. It is a tool to get you through a difficulty, not usually a permanent way of feeding.

When a shield can help

A shield can be useful, ideally with guidance, if:

  • Your baby is struggling to latch or stay on the breast.
  • You have flat or inverted nipples that make latching hard.
  • Your baby is premature or small and tires quickly at the breast.
  • Your nipples are very sore or damaged and you need a short term bridge while they heal. You can read more in Latch and nipple pain.
  • Your baby has become used to a bottle teat and is finding the breast different.

Why support matters

A shield is best started with help from an IBCLC, midwife or breastfeeding specialist. The reason is that, for some babies, feeding through a shield can reduce how much milk they transfer, which over time can affect your supply and your baby's weight. With the right size, a good latch and someone keeping an eye on things, a shield helps rather than hinders. On your own it is easy for a small problem to go unnoticed.

Using a shield well

  • Choose the right size, so the shield fits your nipple comfortably without pinching.
  • Warm it and lightly moisten the edges with water, which helps it stay in place.
  • Roll or evert the shield slightly as you put it on, so your nipple is drawn up into the tip.
  • Wait for a wide open mouth and bring your baby on deeply, so they take the shield and a good mouthful of breast, not just the tip.
  • Watch and listen for steady sucking and swallowing, which tells you milk is moving.
  • Check the shield still has milk in the tip during the feed.

Keep an eye on feeding and supply

Because a shield can reduce milk transfer for some babies, it is worth keeping a closer eye on the signs that feeding is going well.

Moving away from the shield

Many babies move off a shield in time, and there is no need to rush. With support you might warm up the breast and start a feed with the shield, then gently slip it off partway through, or try without it when your baby is calm and not too hungry. Some babies happily use one for longer, and that is alright too. The aim is a baby who is feeding well and a supply that is protected.

Get help from your midwife, health visitor or an IBCLC if:

  • You are using a shield and are not sure your baby is feeding well through it.
  • Your baby's nappies or weight gain are a worry.
  • You want help to use a shield, or to move away from one.
  • Feeding is still painful even with a shield.

Call 999 or take your baby straight to A&E if your baby:

  • Is floppy or unresponsive
  • Will not wake for feeds
  • Is having trouble breathing, or their lips, tongue or gums look blue or grey
  • Has a sunken fontanelle
  • Is visibly jaundiced and unwell with it, for example floppy, hard to wake or not feeding. Yellowing shows most clearly in the whites of the eyes, the gums, and the palms and soles
  • Has dark urine or pale, chalky stools

How a consultation helps

A nipple shield can be exactly the right tool or the wrong one, and the difference is often in the detail. When I see you I can check whether a shield is the right answer for you at all, make sure it is the right size and used well, keep an eye on your baby's feeding and your supply, and help you move away from it when the time is right.