title: Reexamination of ultra-thin nipple shield use, infant growth and maternal satisfaction.
abstract: OBJECTIVE
  The primary objective of the multi-site, international study was to examine trends in weight gain for term infants breastfed with and without ultra-thin silicone nipple shields to determine the effect of nipple shield use on infant weight gain over two months. Additionally, the study examined maternal satisfaction with nipple shield use using a structured survey.
  
  
  BACKGROUND
  The nipple shield may facilitate successful breastfeeding outcomes when indicated. There has been question regarding infant weight gain with nipple shield use. A published pilot study using within-subject design indicated no significant difference in infant test weights and maternal prolactin levels when breastfeeding with and without nipple shields. The current study builds and expands upon the pilot study.
  
  
  METHODS
  Prospective, multi-site, non-randomised, between-subject study.
  
  
  METHODS
  Maternal-infant dyads (n = 54) who used a nipple shield for breastfeeding were studied.
  
  
  RESULTS
  Results demonstrate no statistically significant difference in infant weight gain at two weeks, one month and two months between infants who breastfed with and infants who breastfed without a nipple shield. A majority (89.8%) of the women reported a positive experience with nipple shield use and 67.3% of the women reported that the nipple shield helped prevent breastfeeding termination.
  
  
  CONCLUSIONS
  Infant weight gain was similar in maternal-infant dyads using nipple shields for two months compared to those not using the shields. Maternal positive report of nipple shield use lends to the clinical importance of nipple shield use when appropriately indicated.
  
  
  CONCLUSIONS
  Nipple shield use may facilitate breastfeeding when clinically indicated in maternal-infant dyads without risk of decreased infant weight gain.
authors.affiliation: West Virginia University, School of Nursing, Morgantown, WV 26505, USA. ichertok@hsc.wvu.edu
authors.forename: Ilana R A
authors.initials: IR
authors.lastname: Chertok
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology*; D009558:Nipples; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D011482:Protective Devices; D015430:Weight Gain