If you have any doubts if you have a sufficient amount of milk for your baby, you can stimulate the production of milk by making the baby latch on to the breast more frequently or by expressing milk with the hand or using a breast pump after you have breastfed your baby.

This can be done several times a day until you experience your milk production has increased sufficiently.

A nipple shield is a ”silicone shield” placed on the mother’s nipple when breastfeeding. Using a nipple shield may be a good short- or long-term solution. A nipple shield is used temporarily and if the mother has very flat or inverted nipples, sore, cracked or wounded nipples or if the baby for some reason cannot latch on to the breast.

Your reason for using af nipple shield when breast feeding:_______________________________________________________.

Start by washing your hands with water and soap. Maybe use warm compressions and massage your breast gently towards the nipple before placing the shield on your breast. This process will trigger the release of milk from the breast.

Make the nipple shield softer with water to make it attach to the skin and mould the shield into the shape of a Mexican hat.

The nipple shield carve is placed at the baby’s nose to allow skin contact and to allow the baby to smell the mother’s skin.

Place the shield right on top of the nipple.

Make sure the baby is close to the breast and has latched on to the breast as much as possible. The nipple shield must not be ”pushed under” the baby’s mouth. The baby must open the mouth and latch on to the shield.

It is important to choose a shield that fits the size of the nipple; otherwise it may close off the milk. A small baby mouth is able to latch on to a large nipple/nipple shield.

It is important to note if the baby swallows during breastfeeding and that there is milk in the tip of the shield when the baby unlatches.

Moreover, it is important to observe if the baby passes urine and stools as normal for the age of the baby (See leaflet "Is your baby Thriving").

The baby will normally need feeding 8 times a day. If the baby does not demand to be fed at least 8 times in 24 hours or more, you must wake up the baby.

If you have any doubts about your baby gaining weight, ask the health visitor or your general practitioner to weigh the baby.

Latching on to a nipple shield is different than latching directly on to the breast. During the breastfeeding period, the nipple will change, and both mother and baby will gain more confidence in the breastfeeding situation. This helps the process of weaning from the nipple shield, which requires patience. Both mother and baby must be ready for this. It is important that your baby is awake and interested in nursing.

Allow the baby to breastfeed using the nipple shield until the baby is calm and comfortable but not yet full. Then remove the shield and dry off milk from the breast and continue breastfeeding without the shield. This process can be repeated several times a day for a longer period; choose times when both mother and baby are relaxed.

It may be a good idea ”to start over” and place the baby skin-to-skin on your breast. Lie in bed with no clothes on the upper body and place the baby on your chest. The baby must wear a diaper only. Cover both you and your baby with a duvet to stay warm. The skin-to-skin contact will stimulate the baby to latch on to the breast.

In a few cases it can be necessary to use a nipple shield throughout the breastfeeding period.

• It is important to maintain a good hygiene when cleaning, storing and using the nipple shield. Use one container for the used nipple shield and another container for the clean shield.
• The nipple shield can be used for both breasts for one breastfeeding and must then be cleaned to avoid residual milk from drying up.
• Wash your hands before you start cleaning the nipple shield.
• Rinse the shield in cold running water.
• Pour boiling water over the nipple shield and let it sink into the water for five minutes.
• Remove the water. When the nipple shield is dry, store it in a clean container with a lid.

The photos used are loaned from Medela.