Nipple Shields for Breastfeeding: When They Help, How to Use One, and How to Stop

During a normal feed, your baby draws the nipple and a good mouthful of breast tissue deep into their mouth, then uses their tongue and jaw to compress the tissue and remove milk. If you want the full picture of that mechanism, our guide to the anatomy of the lactating breast and how breastfeeding works walks through it properly.

A shield changes that in three ways:

• It gives your baby a firmer, more consistent shape to latch onto, which helps when the nipple is soft, flat, inverted or swollen.
• It creates a small reservoir at the tip, so milk is immediately available with even weak suction. This is why shields can help babies who tire easily.
• It puts a physical barrier between your baby’s mouth and damaged skin, which can make a feed bearable when it currently is not.

What a shield does not do is fix the underlying reason feeding is hard. It buys you time and comfort while the actual problem gets addressed. That distinction is the single most useful thing to understand about them.

Being honest about this is part of using shields well.

• Pain with no visible damage and no assessment. Pain is information. Covering it without finding out why can let a fixable latch problem become entrenched.
• Suspected tongue-tie. A shield may make individual feeds easier, but it does not resolve restricted tongue movement. It should sit alongside proper assessment, not replace it.
• Low supply or slow weight gain that has not been investigated. Adding a shield without monitoring can obscure a transfer problem rather than reveal it.
• Thrush, vasospasm or bacterial infection. These need diagnosis and treatment. A shield changes nothing about the underlying cause.
• As a first response in the first 24 to 48 hours. Very early feeding is often awkward for reasons that resolve on their own within days.

One more situation worth naming: if your milk sprays and your baby chokes, gulps and pulls off, a shield is sometimes suggested but usually is not the right tool. That pattern often points to an overactive let-down and fast milk flow, which is managed differently.

What the research supports

• Milk transfer in preterm and late preterm babies improved consistently with ultra-thin shields in the studies that measured it.
• Maternal hormone response appears unaffected. A pilot study measuring prolactin and cortisol before and after feeds found no significant difference with or without an ultra-thin shield, which suggests the sensory feedback loop that drives milk production is not being interrupted.
• Infant weight gain was not compromised in the term-baby studies that tracked growth out to two and four months.
• Mothers who use shields frequently report they were the reason they were able to keep going.

What the research also shows

• The evidence base is small and the findings are genuinely mixed. Some studies find no effect on transfer, some find a reduction, and study designs vary a lot.
• Australian research on mothers with persistent nipple pain found that shield use reduced pain scores meaningfully, but in one group also reduced milk transfer. Both things can be true at once.
• A large Danish cohort found shield use in preterm infants was associated with lower rates of exclusive breastfeeding, though cause and effect are hard to separate when shields are given to the babies who were already struggling most.

The practical trade-offs

• Sizing is finicky, and the wrong size can cause the very damage you are trying to avoid.
• Shields need washing and sterilising, which is one more task in a day that already has too many.
• They are easy to lose, which is why most women who rely on one end up owning several.
• Some babies become genuinely reluctant to feed without one, which is manageable but takes patience.

The reasonable conclusion, and the one most lactation professionals work from, is this: shields are a legitimate tool with real benefits in the right situation, used deliberately, with monitoring, and with a plan to stop.

Getting the size right

Size refers to the diameter of the shield’s nipple tunnel, not your breast or bra size. The tunnel should comfortably fit your nipple with a small amount of room, so your nipple can move freely inside it during the feed.

• Too small: your nipple is compressed and rubs against the sides, which causes pain and can cause exactly the damage you were trying to protect.
• Too large: too much areola is drawn in, the seal is poor, the shield slides off and milk transfer drops.
• Measure your nipple diameter at its base, not including the areola, and add a few millimetres. A midwife, lactation consultant or pharmacist can help you do this.

Putting it on

• Wash your hands and the shield first.
• Warm the shield briefly under warm water. It becomes more flexible and sticks better.
• Turn the brim almost inside out, place it over your nipple, then roll the brim back down onto the breast. This creates gentle suction that draws your nipple into the tunnel and holds the shield in place.
• Express a few drops of milk into the tip so your baby tastes milk immediately when they latch.
• Latch your baby the way you normally would, aiming for a wide mouth and plenty of breast tissue, not just the tip of the shield.

What a good feed with a shield looks like

You are checking for milk actually moving, not just for a baby who is attached and quiet.

• You can see milk collecting in the tip of the shield during the feed.
• You can hear or see regular swallowing, with a rhythmic suck-swallow-breathe pattern rather than fluttering.
• Your breast feels softer afterwards.
• Your baby comes off relaxed rather than frustrated.
• It does not hurt. A shield should reduce pain, not create a new kind of it.

Cleaning and care

• Wash in hot soapy water after every feed and rinse thoroughly.
• Sterilise daily while your baby is a newborn, and follow the manufacturer’s instructions for your specific shield.
• Check regularly for tears, cloudiness or stickiness, and replace when the silicone degrades.
• Store in a clean dry container rather than loose in a nappy bag.

This is the part that most often gets skipped. Because a shield can mask incomplete drainage, the safeguard is to watch the outputs rather than assume everything is fine. Effective, frequent milk removal is what drives supply, and our guide to evidence-based ways to increase and protect your milk supply covers the mechanism in detail.

• Track wet and dirty nappies. From around day five, expect roughly five or more heavy wet nappies in 24 hours.
• Keep up with weight checks. Steady weight gain is the single most reliable sign that transfer is adequate.
• Feed responsively and frequently rather than to a schedule.
• If your baby is not gaining well, express after feeds to protect supply while you get the feeding assessed. Do not simply persist and hope.
• Look after your own intake. Milk production is metabolically demanding, and mothers who are running on empty tend to notice it in both energy and supply.

If you want something easy to reach for one-handed during those long feeds, the Nourish Mama lactation cookie range is designed for exactly that situation, with nutrient-dense ingredients that support the extra energy demands of breastfeeding. Please note these cookies contain oats and are not gluten free.

Almost every woman handed a shield wants to know this, and almost none are told it up front. You can stop. Most women do.

There is no fixed timeline. Some babies are off within a fortnight, some take a couple of months, and some outgrow the need suddenly with no transition at all. The single biggest predictor of an easy transition is not pushing it when your baby is hungry, tired or upset.

The approaches that tend to work

• Start the feed with the shield, then slip it off partway through. Once your baby is calm, the let-down has happened and milk is flowing freely, they are far more likely to accept the breast directly.
• Try at the sleepy feeds. A drowsy baby at the start of a nap or in the middle of the night is often far less resistant than a wide awake, ravenous one.
• Express a little first. Softening the areola and getting milk flowing before you latch removes two of the main reasons a baby refuses the bare breast.
• Use plenty of skin to skin. Unhurried, unpressured time at the chest with no expectation of feeding does a great deal of the work here.
• Trim the shield gradually. Some lactation consultants suggest cutting a little more off the tip each week so the transition is incremental. Do this only with professional guidance, and stop if the edges become rough.
• Go one feed at a time. You do not need to drop the shield entirely in one day.

Skin to skin is worth taking seriously here rather than treating as a nice extra. Our article on skin-to-skin contact with newborns explains why it has such a strong effect on latching behaviour.

If it is not working, stop for a week and try again. Babies change quickly, and a baby who flatly refused at four weeks is often a different proposition at eight.

• Using the size that came in the box. Shields are frequently packaged in one standard size, which will not suit everyone.
• Latching onto the shield tip only. Your baby still needs a wide mouth and a deep latch. A shallow latch on a shield causes pain and poor transfer.
• Assuming everything is fine because feeds are comfortable. Comfort is not the same as transfer. Nappies and weight are the evidence.
• Trying to wean off during a growth spurt. Pick a calm week, not a week where your baby is feeding constantly and frantically.
• Treating it as permanent. Many women never revisit the decision because nobody told them it was temporary.
• Going it alone. A shield is one of the clearest cases where a single appointment with a lactation consultant pays for itself.

Please seek support from your midwife, child health nurse, GP or an International Board Certified Lactation Consultant if any of the following apply:

• Your baby is not gaining weight, or has dropped below their expected growth pattern.
• Wet nappies have reduced, or your baby seems persistently sleepy and hard to rouse for feeds.
• Feeding still hurts with the shield in place.
• Your nipples are cracked, bleeding or show signs of infection such as spreading redness, swelling, pus or fever.
• You have been using a shield for several weeks and have had no assessment of why feeding was difficult in the first place.
• You feel like you are running out of road. This is worth saying out loud to someone.

The Australian Breastfeeding Association helpline is free and available 24 hours a day on 1800 686 268. It is staffed by trained breastfeeding counsellors, and it is a good first call at any hour.

This article is general information and is not a substitute for individual clinical advice.