Nipple Shield: When It Helps, How to Use It and How to Wean Off

When a baby just can’t seem to latch, a nipple shield can feel like a lifeline. Sometimes it is. A shield can get a struggling baby feeding at the breast while you work on the underlying problem.

It also comes with trade-offs, especially for milk transfer and supply. Here’s when a nipple shield tends to help, how to pick the right size and use it well, and how to move away from it when the time comes.

What is a nipple shield?

A nipple shield is a thin, flexible silicone cover shaped like a nipple and part of the areola, with small holes at the tip. You place it over your nipple before a feed, your baby latches onto it, and milk flows through the holes.

Cleveland Clinic and La Leche League describe it the same way: a temporary tool, not a long-term way to breastfeed. Experts generally advise using it only when needed and for as short a time as possible.

When a nipple shield can help

A shield may be worth trying, ideally after a lactation consultant has looked at a feed, when:

• You have flat or inverted nipples, or very soft breasts, and your baby can’t get a good hold
• Your baby needs extra stimulation to suck, for example a sleepy baby or one with a weak or disorganized suck
• Your baby is moving from bottle to breast and has learned to expect a firm teat
• Your baby was born early. Advice differs here. La Leche League GB lists prematurity as a reason to consider a shield, and a small study of preterm babies in a neonatal unit, summarized in a 2015 review, found they took more milk with the shield than without it. Cleveland Clinic, on the other hand, lists prematurity among situations where a shield isn’t effective. If your baby was born early, decide together with your baby’s care team or an IBCLC.
• Your nipples are very sore while you and a lactation consultant fix a shallow latch. A shield may ease pain short term, but it doesn’t solve the cause. Our guide to sore and cracked nipples covers what usually does.

A shield is not a treatment for low milk supply, tongue-tie or breast inflammation. In fact, the Academy of Breastfeeding Medicine’s protocol on the mastitis spectrum advises avoiding nipple shields when managing inflammatory breast problems such as clogged ducts.

Choosing the right size

Shields come in sizes measured in millimeters, usually based on the width at the base of the nipple. According to Cleveland Clinic:

• Your nipple should fit inside the cone without rubbing against the sides.
• A shield that’s too small can pinch and restrict flow. One that’s too large may leave your baby with mostly silicone and little breast tissue in the mouth.

La Leche League GB adds that sizes and shapes vary by brand, that you may need to try a few, and that some people need a different size on each side. Full shields usually stay on better than cut-out styles. A lactation consultant can help you check the fit.

How to put on and use a nipple shield

1. Wash your hands and make sure the shield is clean.
2. Turn it almost halfway inside out, holding the brim with your thumbs, so the tip forms a small dimple.
3. Center the tip over your nipple and roll the brim back onto your breast. Your nipple gets drawn into the tip as it unrolls.
4. Smooth the edges down. Dampening the brim with a little water or warming the shield in warm water helps it stick.
5. Encourage the latch. Hand expressing a few drops of milk into the tip, or onto the outside, can tempt your baby.
6. Look for a deep latch. Your baby’s mouth should open wide, with lips flanged out on the brim of the shield, covering the whole teat and part of your areola, not just the tip.

Learning a good latch without a shield is still the goal. Our guide on how to breastfeed walks through latch and positions.

Signs it’s working

• You hear or see regular swallowing.
• Your baby seems satisfied after feeds.
• Your baby has at least six wet diapers a day after the first week, along with regular stools. Our baby poop color chart shows typical diaper counts and colors.
• Your baby is gaining weight as expected at check-ups.

Risks for milk supply

The main concern with nipple shields is milk transfer. Studies are mixed: some older research found babies took noticeably less milk through certain shield types, while other studies found no clear difference. Cleveland Clinic warns that reduced transfer can lead to slow weight gain and, over time, a lower supply, since your breasts make milk in response to how much is removed.

To protect your supply while using a shield:

• Feed often, at least 8 times in 24 hours for a newborn.
• Pump or hand express after some feeds if a lactation consultant recommends it, especially if your baby isn’t draining the breast well.
• Get weight checks. La Leche League GB suggests regular weighing, and for premature babies as often as every few days.
• Watch your breasts. Areas that stay full, sore or red can be a sign milk isn’t being removed well.

If supply does dip, our guide on how to increase milk supply explains what helps.

How to wean off a nipple shield

Plan the exit from the start. Many babies need only a few successful feeds without the shield before they no longer need it, while others take longer. Ideas from Cleveland Clinic and La Leche League:

• Pick calm moments. Try when your baby is drowsy or only a little hungry, not frantic, in a quiet room.
• Spend time skin to skin without the shield, letting your baby explore and latch on their own.
• Get milk flowing first. Pump or hand express until let-down, so your baby gets milk right away.
• Start with the shield, then slip it off partway through the feed or when switching sides, and offer the bare breast.
• Go slowly. Offer the breast without the shield once a day, then more often. It’s fine to put the shield back on and try again later.

Cleaning and care

Cleveland Clinic recommends boiling a new shield for about 15 minutes before first use. After each use, wash it in hot, soapy water (or on the top rack of a dishwasher) and let it air dry completely. Replace it if it cracks or tears.

When to call a lactation consultant or your baby’s doctor

Use a nipple shield with support from an IBCLC (International Board Certified Lactation Consultant) or another breastfeeding professional, and follow up early. Call your baby’s doctor promptly if:

• Your baby has fewer than six wet diapers a day after the first week, very dark urine or few stools
• Your baby isn’t regaining birth weight on schedule, or seems very sleepy and hard to wake for feeds
• Feeds regularly take an hour or more and your baby still seems hungry

Call a lactation consultant if you have pain, damaged nipples, a baby who refuses the breast or questions about weaning off the shield. Find local help on our breastfeeding support page, and see more guides in our Common challenges hub.