Rockville Lactation

Lynnette Hafken, MA, IBCLC

Lactation Consultant

text (fastest response) or call: (240) 888-2123

email: [email protected]

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 nipple, shields, breastfeeding, lactation consultant, rockville


As long as mothers have an understanding of the basic principles of breastfeeding, gadgets can be used as needed to help support breastfeeding. The basic principles of breastfeeding are simple, and they boil down to three things: (1) breastfeeding shouldn’t hurt; (2) the breasts should be emptied frequently and thoroughly enough to provide enough milk for appropriate weight gain; and (3) the baby should be latching or working towards it (if that is mom’s goal).  There are details, but those are the big-picture concepts on which one can base decisions. If the mother is comfortable and the baby is getting enough milk, other details come down to maternal preference, ease of feeding, baby’s preference, and sustainability.

Let’s use the Haakaa passive pump as an example. This device takes advantage of the letdown reflex to collect milk on the side that the baby is not nursing on. Mothers tend to love it because it allows them to extra store milk in a time-efficient manner, with only one thing to clean instead of multiple pump parts. If you understand that the increased breast emptying can cause oversupply if the mother is removing significantly more milk than the baby needs, then there is no risk to using this tool judiciously.

Bottles are another controversial topic. Most breastfeeding mothers in the US use bottles as part of their feeding strategy, whether for expressed breast milk or formula. There are theories of nipple confusion and flow dependence, but no research to support these theories (though plenty of anecdotes). While research does show that bottles are associated with less breastfeeding, it does not show whether bottles cause breastfeeding issues, or whether breastfeeding issues cause the use of bottles—or what other factors might be involved (such as maternal employment and workplace accommodations for breastfeeding mothers). The fact is that most mothers find that their babies go back and forth between bottle and breast without issue. If problems start arising, lactation consultants are a good resource to help get babies back to the breast.

Scales are another piece of equipment that many mothers today are using to track their babies’ weight. These are controversial and usually frowned upon by lactation professionals, unless there is a medical need. I think it’s important that the mother should consider whether having those numbers will cause her anxiety if she sees normal fluctuations, or if it will reassure her. Mothers who have had the experience of a previous child with poor weight gain often find a scale highly reassuring, and they often report being empowered to continue breastfeeding by having the data a scale can provide. Again, with an understanding of a basic principle of lactation—that a baby should gain weight appropriately—there is no reason to avoid knowing this information unless the mother feels it will cause her anxiety, or she feels confident without it.

Nipple shields have been around for centuries; one from the Victorian era is shown in the photo. Usually used for latching difficulties, they can also be used for painful nipples that have not responded to other strategies. The other principle—that breastfeeding shouldn’t hurt—implies that whatever enables the mother to breastfeed comfortably is a good thing. Keeping in mind the theoretical risks to her supply, and also the risk of not solving the pain in a timely manner, I feel that the benefits of trying one (while also exploring the reasons for the pain, of course) outweigh the theoretical risks (there is no evidence that modern nipple shield use results in long-term supply problems).

You can probably tell that my attitude about feeding gadgets is to let the mother decide whether she feels it would be good to try, after education on the basic principles of lactation management. With that education, and her observations of her baby’s satisfaction at the breast and her level of comfort in feedings, she is the best one to determine whether a particular gadget is helpful or harmful in meeting her breastfeeding goals. [back to blog home]