Are nipple guards really needed?

Nipple protectors are silicone or rubber devices, which are used to help breastfeed in certain situations. They are like teats to be placed on the breast making them adhere well.

Later we will see the correct way of their application and how to choose the correct size.

Are they really needed? And when?

The mother becomes aware of this support often even before giving birth because friends and relatives suggest the purchase and other times it is the pediatrician or nursery nursery to recommend it, they rarely come to know them from a midwife.

The reasons why they are recommended are:

  • The appearance of fissures,
  • pain when sucking,
  • Switching from bottle to breast, for example for a premature baby
  • when you have flat nipples.

A nipple guard is absolutely not the solution to all these problems and often should not even be given

Let’s see on a case-by-case basis how to behave:

Presence of fissures or pain when sucking

The first thing to do in this situation is to evaluate the baby’s attack on the breast by a midwife or milk consultant.

A child who has a correct seizure does not bring problems with fissures or pain when sucking. The position of the nurse, the position of the baby and sucking are then verified.

The right breastfeeding position

  • Baby belly belly with his mom.
  • Baby’s nose at nipple height
  • Chin and lower lip touching the breast first
  • Extroflexed lower lip
  • Tongue wrapping “spoon” the lower part of the areola
  • Nipple and most of the areola in the mouth (after the attack)
  • ‘Full’ cheeks, no popping noise during sucking
  • Visible and audible swallowing marks

If fissures are already present, in addition to correcting the attack, to give immediate relief from pain, warm water compresses can be made immediately after feeding. To speed up healing you can use the same colostrum or milk that we produce leaving the breast in the air. . Avoid silver cups in association with creams because they create a humid environment, the skin macerates and only worsens the situation. Nipple protectors are not recommended in case of fissures because they accustom the baby to the presence of the teat, and often do not even improve pain.

Premature baby

The premature baby, who gets tired sucking or has difficulty sucking, can be helped by holding the breast and the baby’s chin (contact your trusted midwife to have her explain the grip): while sucking, the breast is squeezed at the same time so as to help him maintain the attachment and facilitate his sucking.

If, on the other hand, the baby is fed with a bottle and you decide to go back to the breast, then in this case, the use of a nipple shield can be helpful because the consistency is similar to that of the teat.

How are nipple shields used?

First we choose the correct size.

We measure the width of the nipple and then compare it with the size of the base of the various nipple shields on the market. Next we check the length of the child’s palate.

The length of the nipple shield should be shorter than this.

That is why it is useless to buy a nipple shield even before the baby is born.

At the time of use, take the nipple shield, heat it thoroughly in water to soften it, squeeze the central part of the teat in half and let it adhere to the breast. The contact with the skin and the difference in temperature will cause the teat to go back outwards and bring the nipple inside with it. This way, while breastfeeding, it shouldn’t move and cause pain. The use of the nipple shield should be limited in time, but it would be preferable not to use it at all.

Why is its use not recommended?

  • The nipple shield is obviously of a different consistency from the mother’s breast so the baby begins to suck when he feels this strong pressure on the palate from the plastic tip. You will understand that therefore on the occasion in which you remove him he will have difficulty sucking, finding the nipple and therefore remaining attached to the breast. A baby learns to suck… by sucking there’s nothing to do!
  • Suction at the nipple shield is often not correct, especially when the size of the nipple is not controlled and therefore it happens that the newborn attaches only to the tip, consequently not stimulating the breast ducts. A baby who is attached to the mother’s breast, without this interference, stimulates all the glandular tissue with his tongue and mouth and drains the breast in the correct way, thus avoiding obstruction of the ducts, lactiferous pores and mastitis.
  •  Have your midwife teach you to understand for yourself whether your baby is feeding properlyand enough through wet and soiled nappy counts, swallowing cues and how to have a proper latch. In the event that you leave the hospital with a nipple shield or it was necessary to insert it, inform yourself and ask for instructions on how to remove it once the problem that had arisen has been resolved.

How to take them off?

Arm yourself with a lot of patience because it is something that requires gradualness. Try to remove it when the baby is half asleep and offer the breast for short periods of time without it. If the baby has difficulty finding the nipple, try to stimulate its release with your fingers or using a nipple pump (it is a pump) or using the breast pump for 5 minutes before feeding. Always be careful that when the baby makes the attachment, he takes not only the nipple but also a large part of the areola.

Good luck and happy breastfeeding

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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