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Does my newborn (NICU baby) lose any benefits of breastfeeding when using a nipple shield?
—Casey
No! The NICU is one of the places where there do seem to be significant benefits to breast milk. Infants consuming breast milk are at a lower risk of necrotizing enterocolitis (NEC). Importantly, this lower risk is present no matter how the milk is delivered. We know it’s efficacious because of research that used pumped (in some cases donated) breast milk.
By extension, using a nipple shield absolutely does not negate any of these benefits. Nipple shields can be incredibly effective at promoting a good latch, something that is often hard for premature infants.
The primary downside of the nipple shield is less efficient milk transfer. Studies show that the amount of milk that is expressed and consumed is reduced by perhaps 15% with the use of a nipple shield. The reduction seems to be less with newer technologies and better materials, so what you’re likely to experience is probably on the lower end.
There are three possible issues with decreased milk transfer. One is the chance that your child isn’t getting enough to eat. The way you would know that is if they still seem hungry after eating or if they are failing to gain weight at a good pace. A second is that they may just want to eat more; basically, they might be getting less at each feeding than if you didn’t use the shields. Finally, for some people, the lack of breast emptying can lead to a risk of clogged ducts or mastitis.
If you were having any of these issues — your baby was nursing constantly and seeming unsatisfied, was failing to gain weight, or you were struggling with mastitis — it’s worth discussing the tradeoff with your doctor. But beyond that, any benefits of breastfeeding are not impeded by nipple shields.
Very best of luck, and I hope you are all home very soon.
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