Nipple shields: when and how to use them

Breasts and nipples come in all shapes and sizes. Women with small breasts typically make just as much milk as women with large breasts. And most babies, if given the chance, will learn to breastfeed on their mother’s breasts.

While breast size and shape seldom affect a mother’s ability to produce milk, nipple size and shape can make breastfeeding easier or harder for some babies. Click here to learn how to tell if your nipples are everted (protruding), flat, or inverted.

When should I consider using a nipple shield?

 If your baby has trouble latching onto your breast and one or both of your nipples are flat or inverted, try using a breast pump before each feeding to gently pull your nipple out. If that approach doesn’t work, consider using a nipple shield. Though, be sure to talk with your health care provider before using a nipple shield. Too often, nipple shields are used as a substitute for encouragement and support.

What is a nipple shield? 

A nipple shield is a thin silicone device that covers the nipple and the areola—the darker part of the breast around the nipple—and mimics an everted nipple. It’s designed to aid mothers whose nipple size or shape presents a true obstacle to breastfeeding, whose baby (perhaps a premature baby) can’t sustain a latch, or whose baby prefers a bottle nipple and refuses to breastfeed.

What size nipple shield should I use? 

Nipple shields, like babies, come in a variety of sizes. Your health care provider, lactation consultant, or breastfeeding counselor will help you choose a nipple shield that’s the right size for you and your baby. Most newborns do best with a size “small” nipple shield. You’ll know that you’re using the right size if both your nipple and the shield covering it fit into your baby’s mouth. If the shield is too large, your baby will have difficulty maintaining a proper latch and will be more likely to gag. If your nipple touches the top of the raised portion of the shield (the crown), the shield is too small.

How do I use a nipple shield? 

See the steps below for using a nipple shield.

  • Soak in warm water.
  • Gently stretch the shield onto the breast, drawing the nipple and areola into the raised portion of the shield.
  • Tickle your baby’s nose with your shield-covered nipple.
  • Bring the baby toward your breast while holding the nipple shield in place with your thumb and finger. Some nipple shields have a “cut-out,” while other shields are completely round. If you’re using a shield with a “cut-out,” position the shield so that the cutout is beneath your baby’s nose.
  • Remove the shield once your baby starts to suckle and swallow. 
  • After each use, rinse the nipple shield in cold water, then wash in hot, soapy water and rinse well. Store in a clean, dry place. 

how to use a nipple shield breastfeeding

How long should I use a nipple shield? 

Once your baby is able to latch on herself and breastfeed effectively (this may take several days or several weeks), a nipple shield should no longer be used. Nipples shields are meant for short-term use only.

Weigh your baby frequently (at least once a week) while using the shield. Because a nipple shield can interfere with milk transfer in some babies, regular weight checks will help ensure that your baby is getting enough to eat. 

Illustrations by Rick Powell © baby gooroo; this content has been excerpted from Breastfeeding: A Parent’s Guide by Amy Spangler. To purchase an e-version of this book, click here for Amazon Kindle or here for Barnes & Noble NOOK, or visit the iTunes store.

Last updated April 11, 2019

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