Nipple shields are devices that may help with certain problems with breastfeeding (sometimes called chestfeeding). A nipple shield looks like a little hat with a brim. Many have a cutout area on the brim to allow for more skin-to-skin contact. The crown of the hat fits over the nipple, and the brim lies over the dark area around the nipple (areola). Most nipple shields are made of a soft, thin, flexible silicone.

Why are nipple shields used?

Experts usually say to avoid nipple shields because they can affect how well milk is removed from the breast. This can increase risk for problems, such as mastitis. But in some cases nipple shields may be helpful for babies who have trouble sucking, such as:

• Premature infants, who may not be strong enough to breastfeed well.
• Full-term babies with latch-on problems.

Premature babies may not have strong suction. They may not be able to latch on as well as full-term babies. Suction is important because it helps babies get enough of the nipple in their mouth. Nipple shields can help premature babies get a better latch and get enough milk.

Nipple shields may also be used when a person has flat nipples or nipples that point in (inverted) instead of out.

How do you know if you are using nipple shields the right way?

It's important to use a nipple shield correctly. If it isn't used the right way, it could hurt your nipples or your baby may not get enough milk.

The following signs mean you are using the shield correctly:

• You feel your milk let down.
• You can see milk in the shield and hear your baby swallowing.
• Your baby is making a good latch.
• It isn't painful when your baby sucks.
• The shield isn't puckered or dented when your baby is latched.
• Your baby is gaining weight and has wet and dirty diapers.

Getting help

Nipple shields look simple, but there are some tricks to using them. You can get help from a lactation consultant or another breastfeeding expert. Your hospital, doctor, or midwife can help you find an expert in your area.

A lactation consultant can:

• Fit you with a shield that's the right size and shape.
• Help you make sure that your baby is latching on and feeding properly.
• Advise you on how long to use nipple shields.
• Offer tips on how to wean your baby from the shields when the time comes.