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Nipple Shields for Preterm Infants: Effect on Milk Transfer and Duration of Breastfeeding

Section of Neonatology; Rush Children's Hospital, Rush-Presbyterian St. Luke's Medical Center, Chicago; Rush University College of Nursing

Linda P. Brown, RN, PhD, FAAN

University of Pennsylvania School of Nursing

Nancy M. Hurst, RN, MSN, IBCLC

Baylor College of Medicine; Texas Children's Hospital

Diane L. Spatz, RN, PhD

University of Pennsylvania School of Nursing

Janet L. Engstrom, RN, PhD, CNM

Lynn C. Borucki, RN, MS

Ann M. Krouse, RN, MS

East Caro lina Uni versity

This study reports breastfeeding outcomes for 34 preterm infants whose mothers used ultra-thin silicone nipple shields to increase milk transfer. Mean milk transfer was compared for 2 consecutive breastfeedings without and with the nipple shield. Total duration of breastfeeding was calculated for a maximum of 365 days. Mean milk transfer was significantly greater for feedings with the nipple shield (18.4 ml vs. 3.9 ml), with all 34 infants consuming more milk with the nipple shield in place. Mean duration of nipple shield use was 32.5 days, and mean duration of breastfeeding was 169.4 days; no association between these variables was noted. The nipple shield was used for 24.3% of the total breastfeeding experience, with no significant association between the percentage of time the shield was used and total duration of breastfeeding. These findings are the first to indicate that nipple shield use increases milk intake without decreasing total duration of breastfeeding for preterm infants.

Key Words: preterm infant • nipple shield • milk volume • premature • breastfeeding

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