Nipple shield use does not impact sucking dynamics in breastfeeding infants of mothers with nipple pain

Nipple shields (shield) may reduce pain during breastfeeding, but the impact on infant sucking dynamics is not known. We examined the effects of shield use on sucking dynamics, milk removal and nipple pain in two groups of breastfeeding dyads: pain group (PG): shield used for nipple pain; comparison group (CG): no breastfeeding difficulties. Twenty PG (6 +/- 4 weeks postnatal) and 28 CG dyads (8 +/- 6 weeks postnatal) attended 2 monitored breastfeeding sessions with shield use randomised. Within-subject outcomes were compared. PG: shield use did not affect intra-oral vacuum (peak p = 0.17, baseline p = 0.59), sucking frequency (p = 0.20) or milk transfer (40 mL vs 48 mL, p = 0.80; percentage of available milk removed (PAMR) 55% vs 57%, p = 0.88), and reduced McGill pain scores (p = 0.012). CG: shield use increased non-nutritive sucking (10% more, p = 0.049), and reduced nutritive sucking (18% less, p = 0.017) and milk transfer (63 mL vs 31 mL p < 0.001, PAMR 65% vs 36% p < 0.001). For both groups, feeding duration increased by 2 min (p < 0.0001) and non-nutritive portions of the feed increased with shield use. Conclusion: Nipple shield use improved maternal comfort and did not impact milk removal or sucking strength in PG, but significantly reduced milk transfer and nutritive sucking in CG. What is Known: center dot Mothers report that nipple shields reduce nipple pain and enable continued breastfeeding. center dot Concerns that nipple shield use may reduce milk transfer and alter infant sucking patterns are based on limited published evidence. What is New: center dot Nipple shield use is associated with a 25% reduction in pain scores in breastfeeding mothers with chronic nipple pain. center dot Milk transfer is not reduced in dyads that regularly use a shield for chronic nipple pain. center dot Intra-oral vacuums are not impacted by nipple shield use in mothers experiencing pain.

Automated summary

The study found that the impact of nipple shield use on milk removal and sucking dynamics varies depending on the situation. In the pain group, shield use can reduce nipple pain, while in the comparison group, shield use may decrease nutritive sucking and milk transfer.