Nipple shield use does not impact sucking dynamics in breastfeeding infants of mothers with nipple pain

Viviane Silva Coentro, Sharon Perrella, Ching Tat Lai, Alethea Rea, Michael Dymock, Donna Geddes

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Nipple shields (shield) may reduce pain during breastfeeding, but the impact on infant sucking dynamics is not known. We examined the effects of shield use on sucking dynamics, milk removal and nipple pain in two groups of breastfeeding dyads; Pain Group (PG) shield used for nipple pain; Comparison Group (CG): no breastfeeding difficulties. Twenty PG (6±4 weeks postnatal) and 28 CG dyads (8±6 weeks postnatal) attended 2 monitored breastfeeding sessions with shield use randomized. Within-subject outcomes were compared. PG: shield use did not affect intra-oral vacuum (peak p=0.17, baseline p=0.59), sucking frequency (p=0.20) or milk transfer (40 mL vs 48 mL, p=0.80; percentage of available milk removed (PAMR) 55% vs 57%, p=0.88), and reduced McGill pain scores (p=0.012). CG: shield use increased non-nutritive sucking (10% more, p=0.049), and reduced nutritive sucking (18% less, p=0.017) and milk transfer (63 mL vs 31 mL p<0.001, PAMR 65% vs 36% p<0.001). For both groups feeding duration increased by 2 min (p <0.0001) and non nutritive portions of the feed increased with shield use. Conclusion: Nipple shield use improved maternal comfort and did not impact milk removal or sucking strength in PG, but significantly reduced milk transfer and nutritive sucking in CG.
Original languageEnglish
Pages (from-to)1537-1543
Number of pages7
JournalEuropean Journal of Pediatrics
Issue number5
Early online date14 Jan 2021
Publication statusPublished - May 2021


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