Breastfeeding: How and When to use a Nipple Shield

AllisonMS, RDN, CDN

Read time: 5 minutes

What to know about nipple shields

  • Learn when nipple shields might be necessary to support breastfeeding

  • Understand why professional advice is essential

  • Tips on applying the nipple shield correctly

Breastfeeding doesn’t always come easily to mom or baby, and latching issues are fairly common at first. This could lead to a lot of pain for mom as well as baby not getting enough milk. While a few tweaks are often all that’s necessary to get a comfortable, deep latch, occasionally nipple shields are needed temporarily.

What is a nipple shield?

A nipple shield, also called a breast shield, is a flexible silicone nipple designed to be worn over your own nipple and areola while breastfeeding.1,2 It is most often used to help baby latch when there are underlying issues causing difficulty with breastfeeding.

For some mothers, nipple shields may help them continue breastfeeding when they’d otherwise stop.3,8

Why are nipple shields used?

Nipple shields may be recommended to help get mom and baby started with breastfeeding if latching issues are present and/or help create sustained suction during feeding.

Nipple shields may be used for moms who have:

  • Flat or inverted nipples

  • Sore or cracked nipples

  • Nipples that are too large or too small for baby

  • An oversupply3,9

Nipple shields may be used for babies who:

  • Have a weak or disorganized suck

  • Are premature

  • Are transitioning from bottle to breast

  • Have a cleft lip or palate

  • Have low muscle tone (hypotonic babies)3,4

It’s important to chat with your health care provider or lactation specialist before using a nipple shield to make sure this is the right choice for you and your baby. They will also want to work with you and your little one to improve baby’s latch so that the shield may eventually be weaned from.

Read about: Top Breastfeeding Latching Tips

Advantages and disadvantages of using a nipple shield

While a nipple shield can be quite beneficial for some women and babies, if it’s not used correctly, it may just cause more problems.

Advantages: Many moms find that using a nipple shield helps them breastfeed when it may have been too painful to continue before.8 It can help your little one get enough milk, maintain a deep latch, and help prevent further damage to your nipples.3

Disadvantages: Some studies indicate that using a nipple shield may negatively impact your milk supply.9 This could be from baby not coming in direct contact with the breast, not being able to empty the breast due to the shield, or from inappropriate use of the shield.9 Supply could also be impacted by babies who are not able to transfer milk well even without the shield, which lowers how much milk your body makes.8,10

Some professionals feel that using a nipple shield for too long may also make it much harder for baby to breastfeed without it.9

And finally, incorrect use a nipple shield may cause more damage than good.9

Choosing the right size and shape nipple shield

It’s ideal to be under the care of an expert (like your doctor or lactation specialist) when using nipple shields as figuring out which type to get may be confusing.

Size: Nipple shields should be sized specifically to your nipple. An ill-fitted shield will not help correct the initial problem and can even create additional difficulties as well as frustration for both you and your baby. Your baby’s mouth size may also play a part, as a too-big shield can cause a continued shallow latch and poor milk transfer.2,3,5

Shape: The shape of the nipple shield can also make a difference. Some are cone shaped, some look like a bottle nipple, and some are “cherry” shaped. Some may have a cut out on one part to allow baby’s lips to partially touch mom’s skin, and others have a completely round base.1,2

The type of difficulty you are experiencing with latching will help inform which shape is right for you and baby. A lactation specialist can help you figure out which size and shape will work best.

Weaning from a nipple shield

In most cases nipple shields are intended for temporary use.1 While there is no specific time that baby should be weaned from a shield, once baby’s ability to feed improves, it may be time to trial removing it.11

To do this, start doing some skin to skin contact near the nipple without forcing a feed, this will help get your little one adjusted to the feel of your breast and nipple.3 Start a feed with the shield then remove it in the middle of a feed to see if your little one will continue without it.3 Eventually try starting a feeding session without the shield.

You can also hand express so that milk is ready to come out once baby latches to see if that helps baby stay latched without a shield. Additionally, massaging/compressing the breast while baby feeds can help keep milk flowing which may help baby stay interested in continuing to feed.12

If at first your little one does not seem to be doing well without the shield or is getting too frustrated, it could mean they are not ready to transition.11 Instead of forcing them to feed without it, go back to using it for another few days or week and then try again.

Having an expert help you put a plan in place to wean your baby off the shields is essential.1,3

Get support

If you’re considering using a nipple shield, discuss this with your doctor and lactation specialist. You’ll want to be sure you and your baby could truly benefit from one or if working on baby’s latch without a nipple shield may be enough.

Even if a shield is necessary, working on baby’s latch will be critical to eventually weaning from it, as well as for preventing additional nipple damage.

Seek out a seasoned lactation consultant (LC). The right LC can evaluate your needs, your baby’s latch and positioning, and assess best treatment and support options. If you do need shields, the lactation consultant can also fit you properly, guide usage, and help determine when you may stop using them.1,3,4

Need some guidance on whether a nipple shield may be needed? Reach out to our team of registered dietitians and lactation consultants for free! They’re here to help on our free to live chat from Monday – Friday 8am - 6pm (ET), and Saturday – Sunday 8am - 2pm (ET). Chat Now!

Tips for using nipple shields

How to use a nipple shield

The shield should be suctioned onto your breast. The best way to do this is to:

  • Turn the shield partially inside out

  • Place the shield over your nipple

  • Press down on either side of the nipple and smooth it over your breast/areola. The nipple should be drawn into the narrow tip.

  • Rinsing the shield in warm water may help it “stick” to the breast better. The warming of the shield may also help with your let down.

  • You can try to ‘preload’ the tip of the shield’s nipple with milk to help entice baby.

  • Sometimes milk leakage or baby’s saliva can cause the nipple shield to slide around, and you may need to re-rinse or re-position the shield. Remember that the shield will be less likely to slide around if you follow the above steps and make sure the shield is suctioned on properly.1,2,3

Get proper latching and positioning support

Even while using nipple shields, you’ll still want to make sure baby is opening their mouth wide and latching deeply.3 Working with a lactation consultant can help you and your baby find the position and latch technique that works best.

Read more:

Top Breastfeeding Latching Tips

6 Breastfeeding Positions for You and Your Baby

Keep your supply up

Because using a nipple shield may interfere with milk supply, it might be necessary for some moms to pump in addition to breastfeeding. This is especially important if baby has a weak suck and is not able to empty the breast on their own.

Should you need to, pumping after each breastfeeding session will empty your breasts, helping to maintain your milk supply.11

Chat with one of our experts or your lactation consultant to see whether pumping is necessary. Not all moms may need to take this extra step!7

Some professionals recommend that moms massage and compress their breasts while nursing with a shield to help the milk flow more consistently and evenly.3 This can also help your little one take in more milk during the feed, better emptying the breasts.

Any extra milk you pump can be frozen for later use or used to supplement your baby if necessary.

Read more:

How to Support a Good Milk Supply

Top Tips for Breast Pumping

Learn about supplementing with breastmilk in this article.

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Our Happy Baby Experts are a team of lactation consultants and registered dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too! They’re here to offer personalized support on our free, one-on-one, live chat platform Mon-Fri 8am-6pm (ET), and Sat-Sun 8am-2pm (ET). No appointment needed, no email or sign-up required. Chat Now!

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For more on this topic, check out the following articles:

Dealing With Low Milk Supply

What To Do About Sore Nipples While Breastfeeding

What Can I Do To Prepare To Breastfeed?

What is Paced Bottle Feeding?