Wednesday, 26 October 2011

The Problem with Nipple Shields

Nipple shields – friend or foe? They are often touted as a ‘necessary purchase’, but perhaps we should be paying more attention to just who is doing the suggesting.

Nipple shields are artificial nipples worn over the mother’s nipple during breastfeeding. Modern nipple shields are made of soft, thin, flexible silicone and have holes at the end of the nipple section to allow the breast milk to pass through. Research on the use of nipple shields has revealed reduced milk transfer of up to 58 percent. It is therefore unsurprising that in Brazilian law nipple shields are included in its list of unmarketable products because their promotion and use can do harm to breastfeeding. La Leche League has commented that:

“Often, with use of rubber shields, infants are not able to compress the maternal milk sinuses, which can lead to long-term milk production problems and increased nipple soreness and damage. Since the infant has to rely on suction alone to transfer milk, nipple shields can drastically reduce his milk intake, potentially causing slow or inadequate weight gain. There are reports that even the thin silicone nipple shields cause reduced milk intake and present a potential for reduced maternal milk supply and nipple damage with improper placement.”

Today I made the decision to complain to Boots (large UK chain of cosmetics and drug stores). The reason? In their Bump to Birth, Parenting Club Magazine they currently have a Hospital Bag Essential feature which at the top states the following: “Pop these b-day must haves in your hospital bag and put it ready to go, by your front door” and then they include Boots Maternity Silicone Nipple Shields.  There is some small print below which says “Not for use until breastfeeding is established”.  So logically, what are they doing in a hospital bag essentials list!?

Now don’t get me wrong, nipple shields have a place in helping a minority of mothers to continue with breast feeding where they would have otherwise given up; for instance, to improve latch when a mother has flat or inverted nipples. However I can’t help thinking that their inclusion in this pregnancy magazine is misleading. Even with the small print, the article could easily lead readers to assume that nipple shields are a good idea to use from the start. By suggesting that all mothers may need them, the article is subtly undermining breastfeeding. Surely nipple shields are a product that would be better to buy as and when needed rather than just in case? The only person that should be recommending their use is a qualified lactation consultant, or similar. It's important that the baby's latch is assessed by a professional before a mother resorts to using them.

So why did Boots feature an unnecessary and potentially sabotaging product in a pregnancy guide? The first, and most obvious reason, is to increase their sales of nipple shields. Currently the cost per pair is £4.39. If every new mother were to purchase just one pair, this would give Boots over three hundred million pounds every year in England and Wales alone.

It is also relevant to note that Boots work in partnership with other companies. Their parenting club is sponsored by formula company Cow&Gate and bottle manufacturer Phillips Avent. Furthermore, Boots Parenting Club sponsored The East Midlands Baby and Toddler Show last week, alongside their buddies Philips Avent and formula company SMA. With these facts in mind, it becomes easier to see why sabotaging breastfeeding might be in Boots and their ‘associates’ best interests. 'Trust Boots' is their slogan. Would you?

So how about joining me? Type an email, write a letter or pick up the phone. Boots claim that they aim to respond to emails within 2 days.


Click here


Boots Customer Care
PO Box 5300
NG90 1AA


UK – 0845 070 8090
ROI – 1890 708 091
(Monday to Friday – 08:30 to 19:00
Saturday and Sunday – 08:45 to 17:00)


Helena said...

They sent me an email telling me why my son needs "growing up milk" instead of cow's milk from age 1. Not one mention of breastfeeding or continuing to breastfeed.

Alpha Parent said...

Sadly that's unsurprising. I'm assuming they failed to mention that there is no evidence to show that "growing up milk" has any more nutritional value than regular full-fat cows milk.

Helen Marland said...

I sort of agree/disagree lol. I have to say it's a bit of an idealistic scenario, not all women have access to lactation consultants and those that do don't always have positive experiences. As for it only being professionals that can advise the use of the shields, again, women need to have access to said professionals.

A friend in my baby group had been to see professionals about the use of them and was treated like an idiot for asking permission and not just getting on and trying them.

Yes they may be a last resort but if you don't have access to lactation consultants, bf clinics and the like it would be helpful to at least be aware that such products exist which many women are not.

I do however agree that the way bots is marketing them is misleading.I have to say I received many lists as an expectant mother from midwives, online baby communities, the nhs and the NCt. All of them had a number of items that weren't actually essential to purchase on there so it isn't just isolated to businesses seeking profit.

Suzanne said...

Whilst you're at it tell them to change the design, boots nipple shields have not worked for any mother I've supported who has bought them. They look like a dummy with a narrow opening and bulbous teat, the holes are far too small for baby to breastfeed without getting frustrated and they are not firm enough to help the baby milk the breast. And mothercare own brand ones are exactly the same, I think they get they must get them from the same place. So not only are they putting on a must buy list, a mother who may have a genuine need to use shields would still not be helped as Boots nipple shields don't ruddy work.

I don't think there's much evidence that thinner shields interrupt milk supply in the same way as the rubber ones did, but incorrect use will in turn lower milk supply. It is very easy for a mum to think baby is feeding with shields when they're just sucking not suckling which of course would then lower supply. It is so important to get feeding assessed and daily support to start with if shields are being used. Most importantly of all, teach the mums to listen for the correct suck/swallow pattern, show them what an effective feed looks like. If the baby isn't feeding well on the shield they may as well not be there.

Shields have their uses, sometimes they're the difference between mums breastfeeding or not. They're not a first resort but I for one am thankful the ones that actually work are there. There's quite a long history of shields, in the Thackray medical museum there is a silver pair from the 1800's.

Shame on Boots, I wonder if this is why mums do tend to have the boots ones if they are trying shields? (I work with newborns, so see it a lot), I think for a while they also stopped selling other brands but now stock Medela again, who also had a more insidious marketing campaign aimed at bf supporters that was geared towards selling more shields.

Bad Good Mother said...

I see where you are coming from but as a breastfeeding mother of three (three under three) they absolutely SAVED me. I had totally normal nipples - nothing inverted about them.. I always knew I wanted to breastfeed but OMG the pain!! I found the pain worse than labour. I fed No1 for a week with tears in my eyes, no formula, just breast milk, no mastitis, just sore nipples. I was latching on perfectly I just had sensitive nipples.

Had a friend not suggested nipple shields that I had never heard of then I would have given up then and there and forever been heart broken, but instead I put up for it another night and sent my husband out the next morning to find these plastic life savers.

I jokingly called them nipple condoms for a few weeks while I used them (and I agree that the Boots ones were the worst, I tried every brand) but after a few weeks I had it!! I was a successful breastfeeding mother and as proud as punch thanks to nipple shields!

I hate to say it but I, like Boots now recommend to many of my friends who are new mothers planning to breast feed to get some 'just in case' as honestly I never want anyone going through what I did.

These bags that they give out to new mums have Sudocrem just in case babies have nappy rash, different nappy brands to try, vouchers etc. what is the problem with putting nipple shields in if it means some extra mothers might TRY breast feeding or better NOT give up when struggling??

Alpha Parent said...

To their credit, Boots were fast in replying to my complaint. But is their response satisfactory?

"Thanks for contacting us about your concerns with our Parenting Club magazine and the information regarding the nipple shields. I'm really grateful for the time you've taken to let us know how you feel.

I'd like to assure you that we do detailed research when putting together the magazines. We do try to ensure the literature provided is useful to our customers and have used customer feedback to help us try and get this right.

Please be reassured I have made sure that our Parenting Club Team are aware of your comments, so your feedback can be raised at their next review. We will continue to monitor this and make any changes considered appropriate."

Lintunen said...

I agree that in a normal situation nipple shealds are not necesary. In my case though, they were crucial. When my son was born (c-section) he had an infection and was transferred to the children's unit. Me, recovering from surgery, needed a wheel chair to get to him. I was able to visit 2-3 times a day and stay 2-3 hours at a time. So breastfeeding was largely replaced by bottlefeeding donated breastmilk. When we were released from the hospital, my son didn't want to latch on to a bear breast. I had to use nipple covers to give the illusion of a bottle and also give him some formula. It took about a weeks for my milk to rise and another week to get rid of the nipple shealds. In cases like mine, I'd say that the nipple sheald has it's use.

kais mom said...

I used nipple shields from the time my son was born. The nurse in the delivery room noticed that my nipples were short, maybe a little flat and she gave me a nipple shield that I used from the time he was born to the time my son was more than a month old. I breast fed him for 12 months successfully. I never had a problem with milk production and he was always slightly above average in size and ridiculously healthy in every other way. I had no idea that nipple shields had any negative side effects and I have never experienced any. I fear that a woman will not try a nipple shield if she reads this article first. They saved me as a woman with short nipples. But I realize not every woman is like me.

Ralph Kent said...

I'm interested in your figures - about if every new mother in the UK bought one pair of nipple shields and Boots would make £300m. Are you genuinely suggesting that there are over 68 million new mums in the UK every year?

Alpha Parent said...

Ralph there are some figures here:

By new mother I mean 'mother haven just given birth'.

Alpha Parent said...

Ralph, there are some statistics here:

By 'new mum' I mean 'woman having just given birth'.

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