Using a Nipple Shield: Benefits and Concerns
Medically reviewed by Dr. Rachel Kim, MD, RDN · Pediatric Nutrition Specialist
Content reviewed against published AAP, La Leche League, WHO guidelines
Last reviewed:
Feeding challenges are one of the most common concerns new parents face. When it comes to using a nipple shield: benefits and concerns, here is what the guidelines recommend.
The short answer
A nipple shield is a thin silicone cover placed over the nipple during breastfeeding, often used to help babies who struggle to latch due to prematurity, flat or inverted nipples, or tongue tie. When used correctly and with proper sizing, nipple shields can be a valuable tool that allows breastfeeding to continue. Many concerns about decreased milk supply are related to improper use rather than the shield itself.
Key takeaways
- A nipple shield is a thin silicone cover placed over the nipple during breastfeeding, often used to help babies who struggle to latch due to prematurity, flat or inverted nipples, or tongue tie. When used correctly and with proper sizing, nipple shields can be a valuable tool that allows breastfeeding to continue. Many concerns about decreased milk supply are related to improper use rather than the shield itself.
- Usually normal when: Your baby latches and feeds well through the shield with audible swallowing and good weight gain
- Call your doctor if: Your baby is not gaining weight or is losing weight while using the nipple shield
- Varies by age — see the age-by-age breakdown below
“The AAP recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, for 2 years or beyond.”
This is one of the most common questions parents ask. Searching for answers means you care.
What Parents Should Know
According to AAP, La Leche League, WHO guidelines, a nipple shield is a thin silicone cover placed over the nipple during breastfeeding, often used to help babies who struggle to latch due to prematurity, flat or inverted nipples, or tongue tie. When used correctly and with proper sizing, nipple shields can be a valuable tool that allows breastfeeding to continue. Many concerns about decreased milk supply are related to improper use rather than the shield itself. At 0-3 months, nipple shields are most commonly introduced in the early weeks when latch difficulties are identified. If your baby is premature or has trouble latching, a shield can make the difference between breastfeeding and not. It is important to work with a lactation consultant to ensure proper fit, as an incorrectly sized shield can reduce milk transfer. Monitor your baby's weight gain closely during this time. It is generally considered normal when your baby latches and feeds well through the shield with audible swallowing and good weight gain. However, you should contact your pediatrician promptly if your baby is not gaining weight or is losing weight while using the nipple shield.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
Nipple shields are most commonly introduced in the early weeks when latch difficulties are identified. If your baby is premature or has trouble latching, a shield can make the difference between breastfeeding and not. It is important to work with a lactation consultant to ensure proper fit, as an incorrectly sized shield can reduce milk transfer. Monitor your baby's weight gain closely during this time.
3-6 months
Many families begin working on weaning off the nipple shield during this period as the baby's mouth grows and their latch strengthens. Try offering the breast without the shield when your baby is drowsy or calm, and use the shield as a backup. Some babies transition easily while others need a more gradual approach. There is no rush to stop using a shield if it is working well for your family.
6-12 months
If you are still using a nipple shield at this age, there is no medical reason you must stop as long as your baby is gaining weight well and your supply is maintained. Some babies naturally refuse the shield as they get older and their latch improves. If you want to wean off the shield, a lactation consultant can help develop a strategy.
What to Tell Your Pediatrician
- Describe when you first noticed using a nipple shield: benefits and concerns and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby's weight gain has slowed since starting the nipple shield.
- Mention if you notice your milk supply seems to be decreasing and feeds feel less effective.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby latches and feeds well through the shield with audible swallowing and good weight gain
- You were advised to use a shield by a lactation consultant due to latch difficulties or nipple shape
- Your baby occasionally feeds without the shield but prefers it for most sessions
- You find the shield helpful for managing nipple pain while a latch issue is being addressed
- Your baby's weight gain has slowed since starting the nipple shield
- You notice your milk supply seems to be decreasing and feeds feel less effective
- You want guidance on the correct shield size or help weaning off the shield
- Your baby becomes very distressed when you attempt to feed without the shield
- Your baby is not gaining weight or is losing weight while using the nipple shield
- You notice signs of dehydration such as fewer wet diapers, dry mouth, or lethargy
What You Can Do at Home
- Keep track of when you notice using a nipple shield: benefits and concerns — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby latches and feeds well through the shield with audible swallowing and good weight gain — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Offer feeding in a calm, distraction-free environment. Avoid forcing or pressuring your baby to eat.
- While monitoring at home, seek immediate care if your baby is not gaining weight or is losing weight while using the nipple shield.
Related Resources
Feeding & Nutrition Guide
Complete guide to breastfeeding, formula feeding, and solid food introduction.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is using a nipple shield: benefits and concerns normal?
When should I call the doctor about using a nipple shield: benefits and concerns?
When is using a nipple shield: benefits and concerns normal?
What causes using a nipple shield: benefits and concerns?
What should I mention to my pediatrician about using a nipple shield: benefits and concerns?
Is using a nipple shield: benefits and concerns normal at 0-3 months?
Is using a nipple shield: benefits and concerns normal at 3-6 months?
Should I go to the ER for using a nipple shield: benefits and concerns?
Does using a nipple shield: benefits and concerns go away on its own?
References
- [1]American Academy of Pediatrics. Common Breastfeeding Challenges. HealthyChildren.org. AAP
- [2]La Leche League International. Nipple Shields. La Leche League
- [3]World Health Organization. Breastfeeding recommendations. WHO
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Using a Nipple Shield: Benefits and Concerns.
Things to mention
- Describe when you first noticed using a nipple shield: benefits and concerns and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby's weight gain has slowed since starting the nipple shield.
- Mention if you notice your milk supply seems to be decreasing and feeds feel less effective.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your baby's weight gain has slowed since starting the nipple shield
- You notice your milk supply seems to be decreasing and feeds feel less effective
- You want guidance on the correct shield size or help weaning off the shield
Urgent signs to report immediately
- Your baby is not gaining weight or is losing weight while using the nipple shield
- You notice signs of dehydration such as fewer wet diapers, dry mouth, or lethargy
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of using a nipple shield: benefits and concerns are normal. Talk to your pediatrician if your baby is not gaining weight or is losing weight while using the nipple shield.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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