How to Use a Nipple Shield for Flat or Inverted Nipples: An IBCLC Guide

Updated May 11, 2026

A nipple shield is a flexible silicone nipple that is placed over the mother’s nipple during breastfeeding. You might receive one in the hospital if your baby is having difficulty latching. Latching issues can be caused from tongue-tie or from inverted or flat nipples.

Nipple shields can be helpful if you have flat or inverted nipples, a preterm delivery, or a low-birth-weight baby.

They work best as a temporary bridge, not a permanent feeding tool. A nipple shield gives you a way to keep feeding while you and your baby work toward a direct latch. Our team of IBCLCs uses nipple shields in many of our flat and inverted nipple consultations, but never without a weaning plan built in from the very first visit.

Two misconceptions come up constantly in our consults:

1. The first is that using a nipple shield means you’ve given up on or failed breastfeeding. You haven’t. It means you found a way to keep going.
2. The second is that once you’re on a nipple shield, you’ll never get off it. For most parents, that’s not true. But getting off it does require a plan, the right technique, and often some professional support.

Below, we break down exactly how to use a nipple shield safely, how to protect your milk supply while using it, and how to wean from it when you’re ready.

When is a nipple shield actually needed?

Nipple shields aren’t right for every situation. We think they’re given out far more freely than they should be.

In the days right after birth, hospital IV fluids cause temporary breast engorgement that can flatten even normally protruding nipples. Many parents are handed a nipple shield in the hospital for what is actually a temporary, fluid-related issue, not true flat nipple anatomy. If this was your experience, there’s a good chance your nipples would have protruded on their own within a few days as the engorgement resolved.

That said, nipple shields are genuinely useful when:

• Your nipples are flat or inverted and your baby cannot achieve suction; the shield creates a firmer surface for baby to latch onto
• Your baby was born preterm or with a small mouth and needs the extra structure to create suction
• Your baby has a tongue or lip tie that is limiting latch depth while you await a tie evaluation or procedure
• Your baby is frustrated and refusing the breast entirely; the shield can reduce that frustration enough to get a feeding in

Will a nipple shield hurt my milk supply?

This is the question we get asked most about nipple shields. A nipple shield used correctly, with targeted pumping, does not necessarily reduce your milk supply.

Here’s what the evidence actually shows:

An observational study found that silicone nipple shields produced 80% breastfeeding success by Day 28. A 2024 study found that shield use, particularly in the early weeks without professional guidance, was associated with a higher risk of exclusive breastfeeding interruption before 6 months. The clinical summary from Oxford’s Centre for Evidence-Based Medicine states: “There is no consensus as to whether nipple shields are safe or helpful, and current guidelines rely on low-quality evidence.”

Sources:
https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1115_dec_21.pdf
https://pubmed.ncbi.nlm.nih.gov/38006626/
https://www.cebm.ox.ac.uk/news/views/nipple-shields-the-first-systematic-review-after-at-least-300-years-of-use

What that means in practice: the shield itself isn’t the problem. Using it without understanding how it affects milk stimulation, and without compensating for that, is where things go wrong.

When a baby latches onto a nipple shield, less of your nipple and areola tissue is being stimulated compared to a direct latch.
Less stimulation = less signal to produce milk. Over time, without a plan to maintain supply, some parents do see a drop.

How TLC approaches this:

Every time we recommend a nipple shield, we also recommend a regular pumping schedule to run alongside it. After each shield feeding (or at minimum, a few times a day) brief pumping keeps the breast stimulated and milk-production signals strong. We assess flange sizing at the same time, because an ill-fitting flange during pumping creates its own damage and inefficiency.

The TLC protocol at a glance:

1. Use the nipple shield for the feeding
2. Follow with 10–15 minutes of pumping, or use a wearable pump between feeds
3. Check flange fit; this matters more than most people realize
4. Weigh your baby at follow-up visits to confirm adequate milk transfer

Getting a good latch with a nipple shield

Using a nipple shield doesn’t automatically produce a good latch. Baby still needs to draw breast tissue into their mouth, not just the tip of the shield.

Signs that a shield feeding is going well:

• Baby’s chin is touching your breast, not hovering
• You can see baby’s jaw moving rhythmically, not just flutter-sucking at the tip
• You can hear swallowing within the first minute or two
• The shield doesn’t collapse inward or slip during the feed
• After 15–20 minutes, baby releases satisfied and drowsy

Signs something is wrong:

• The shield is filling with milk but baby seems frustrated
• Baby is nursing for 30+ minutes but still seems hungry
• Baby is gaining weight slowly
• You can see milk pooling in the shield with little swallowing

How to wean from using a nipple shield?

Weaning from a nipple shield is a process, not a one-time event. Most parents who work with us don’t completely eliminate the shield after the first visit, they gradually reduce dependence over days or weeks until direct latching becomes the norm.

Here’s the protocol we use with clients who have flat or inverted nipples:

Step 1: Prepare the nipple before every feed (with or without the shield)

For flat or inverted nipples, the nipple needs to be drawn out before baby latches. Do one of the following for 2–5 minutes before each feeding:

• Brief pumping – the most effective way to draw out a flat nipple and start milk flowing before baby even latches
• Manual stimulation – roll the nipple gently between your fingers, or use the “press back” technique: press the breast tissue back from the areola so the nipple protrudes
• Reverse pressure softening – if you’re engorged, push fluid back away from the areola before latching so the nipple has room to protrude

Step 2: Offer the breast without the shield first

Every single feeding. Even if baby only stays on for 30 seconds. If baby gets frustrated, use the shield, that’s what it’s there for. But always try first. That 30 seconds of unshielded practice, repeated 8 times a day, adds up.

Step 3: Start with your easiest feeds

The first feed of the morning (when your breasts are full, milk is flowing readily, and baby is calm but hungry) is your best opportunity to practice without the shield. Avoid trying to wean the shield during a tired or very hungry feed. Set yourself up to succeed.

Step 4: Try mid-feed removal

Once baby is actively nursing with the shield and you’ve heard several swallows, try gently sliding the shield off and continuing without it. Baby is already in a sucking rhythm and the nipple is often more everted from the suction. Many parents find this more successful than starting without the shield entirely.

Step 5: Track progress, not perfection

The progression we typically see in TLC follow-up visits:

Visit 1: Shield in use, wean plan established

Visit 2 (1–2 weeks later): Practicing without shield, some success at certain feeds

Visit 3: Reduced shield use, direct latch at majority of feeds

Visit 4+: Independent latch established; remaining work on supply and positioning

This visit progression data is derived from dozens of de-identified TLC case records. Special thanks to the TLC IBCLC Team members (Annalisa Burch, Ashley Lee, Cambria Garrett, Laura Franchow, Mindy Nunes) for providing their expertise.

Some babies wean from the shield on their own, particularly those who used it because of prematurity or small mouth size. As they grow, their latch mechanics catch up and the shield becomes unnecessary. For flat or inverted nipple cases, active weaning work is almost always required.

To give you even more help, you can read the transcript or watch the IGTV recording about nipple shields.

Watch the video on Instagram.

When to contact an IBCLC about your nipple shield

A nipple shield works best as a supervised tool, not a solo one.

Contact an IBCLC if:

• Your baby is feeding for 30+ minutes but seems unsatisfied after
• Your baby is not regaining birth weight by 2 weeks, or is losing weight
• You’re seeing fewer wet or dirty diapers than expected (At least 6 wet diapers and 3-4 dirty diapers per day…read more here.)
• You’ve been on the shield for more than 4 weeks with no progress toward weaning
• You’re experiencing nipple pain, cracking, or plugged ducts while using the shield
• You feel completely dependent on it and don’t know how to move forward

At TLC, we see nipple shield cases across every stage: in the hospital, in the first days home, and weeks or months in. If you’re struggling, that’s what we’re here for.

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Originally posted August 22, 2019