Have you tried starting the session with the shield and then removing it? I know that is sometimes recommended because the nipple will be drawn out and easier to latch on to.
I have used a shield and didn't experience leaking. Can you tell if it's coming out from underneath the shield or if it's coming from where her mouth seals around the shield? Under the shield may indicate wrong size shield, although if everything else is going well and it's not too much, then I wouldn't worry too much. If it's coming from where her mouth forms a seal around the shield, then it may give insight into why she cannot nurse without it. Either her latch is weak, she cannot form a seal, or she breaks the latch to catch her breath.
Here are some suggestions from ************
Weaning from a nipple shield
These things can help you start to wean from the shield:
* Ensure good positioning and latch--
o Make sure that when positioning your baby to nurse you are holding him so that his whole body faces yours. He should not have to turn his head to nurse.
o Wait for the baby to open very wide - as with a yawn - before you attempt to latch him on.
o Once he has opened this wide - and it may take patience waiting for him to do so - pull him in real close making sure that he takes as much of the breast into his mouth as possible. His chin and nose should touch your breast. His lips should be flanged out - like a rose petal or a fish's lips. If they are not, use your finger to flip them out manually.
* Before attempting to feed at all, pump a few minutes. This will elicit let-down so that baby gets a quick reward. It will also elongate the nipple for him.
* Also before feeding, offer him your index or pinky finger nail-side down to suck on for several minutes. This suck-training teaches him to drop his tongue down as he must do with breastfeeding. With the shield (much like a bottle nipple) he may push his tongue to the roof of his mouth to slow the flow of milk.
* Breastfeed frequently - as often as you can. Attempt to feed before he gets too hungry - when he is sucking on his fingers or rooting, but before he cries. If you can catch him early he may be more willing to work with you. You also might try nursing when he is a little drowsy. Some babies are more willing to take the breast when they are semi-asleep than when fully awake.
* Try different nursing positions.
* Nurse while in motion - as you walk, sway, rock, bounce, etc.
* Provide lots of skin-to-skin contact when nursing and at other times as you can. Undress baby to his diaper and remove your blouse if possible. Try nursing while you both enjoy a warm bath.
* Drip expressed breastmilk (or formula, or sugar water if no ebm is available) over your nipple in the corner of the baby's mouth using an eyedropper or feeding syringe while he is at the breast.
* If baby becomes upset as you are trying, stop and attempt to calm him before trying again.
These last ones pertain more to taking the shield away:
* It may help if you compress your breast and hold it firmly about 1 1/2 inches from the base of your nipple toward the chest wall (usually at the edge of the areola just past where your baby's lips will be) - like squishing down a big thick sandwich on a roll to take a bite. Holding the breast this way makes your nipple more firm like the shield. Keep holding it like that until it feels like baby is sucking well, and then slowly release the grip.
* Apply ice to your nipple before feeding to harden it.
* Try to notice if there are certain times of the day or positions that he seems more receptive during and build on those.
* Try offering the breast without the nipple shield, particularly when baby is rather sleepy. Sometimes once they take the "bare" breast a couple times, they'll continue with no problems.
* If baby doesn't take the breast without the shield relatively easily, give it to him with the shield. DO NOT allow him to become frustrated at the breast, that will only make him more resistant to breastfeeding. Allow baby to build trust that nursing will work and will be ok, even if that means using the shield to make it familiar and easy for him. Once he builds trust, start to remove the shield after he has been on for awhile
* After baby is nursing well and let-down has occurred, attempt to remove the shield quickly and relatch baby. Very gradually, start to remove it earlier and earlier in the feeding until you don't need it at all.
* Sometimes it works to offer the first breast with the shield and the second one without it, if your baby takes both breasts in one feeding.
* In the beginning, you may not want to take away the shield at every feeding so the baby relaxes and doesn't look for you to remove it every time.
* You may hear the recommendation to cut away the tip of the nipple shield, a little each day, until it's gone. This is not recommended for silicon shields, because it will leave sharp edges.
Be sure not to make this a battle with the baby, or he will resist more. Don't obsess with weaning off the shield to the point that you're robbed of the joy of breastfeeding. As long as your baby is gaining weight well, then you have some time to play with. Keep trying as often as you can, and give it some time. There are some reports of moms continuing to use the shield for their whole breastfeeding experience, but most moms have taken anywhere from 2 days to about 4-5 weeks to accomplish completely weaning from the shield. Be patient with yourself and your baby while you work through this transition.
Hope some of this helps. I did not use a nipple shield but I have observed my lactation consultant helped some mothers with this weaning in support groups. She gives much of the same advice as listed in the kellymom article. She noted that it can be quite a challenge to wean from a shield but with patient persistence, it is usually successful. Good luck!
How old is the baby? I also have very small nipples. I had to use the shield for almost 3 months and then I would let her start with it then take it off. Eventually she started latching on without it and I was able to toss it away.
She's only 7 weeks. She's only been nursing 3 weeks now. Before I was pumping and bottle feeding. She won't take a bottle anymore.
I think the milk is leaking from her mouth. She has been congested since birth. I suction her and use nasal drops. Even when bottle feeding she has milk all over her chin and neck.
If your worried because of small nipples try pumping for a few min to make the nipple larger, then try to get the baby to latch. I'd strongly suggest starting when the baby is sleepy, I found when our son was awake he had more issues accepting it with out the shield.
I've finally gotten her off the shield. It's been a week now and she's doing great! We've had to use the shield a few times in the morning when I was engorged and didn't get up with enough time to pump a little bit first.
Thanks everyone for all the suggestions.