How to Use a Nipple Shield for Breastfeeding
What a nipple shield is and when it may help, how to choose the right size, a step-by-step guide to applying it correctly, signs that it's working (and signs it isn't), how to wean off a shield when your baby's latch improves, and how shields differ from silver nursing cups.
A nipple shield is a thin, flexible silicone cover that fits over the nipple and areola during breastfeeding. It creates a slightly firmer surface that some babies find easier to latch onto — particularly when latch difficulties make direct breastfeeding painful or ineffective.
Nipple shields are a temporary bridge, not a permanent fix. They're designed to help you and your baby through a specific difficulty while you work on the underlying issue with professional support. The American Academy of Pediatrics and most clinical guidelines recommend using them under the guidance of a lactation consultant (IBCLC) who can ensure correct sizing, placement, and a plan for weaning off when the time is right.
What Is a Nipple Shield?
Modern nipple shields are made of ultra-thin medical-grade silicone — very different from the thick rubber or plastic versions used decades ago. They consist of a dome-shaped tip (where the nipple sits) with small holes at the end for milk to flow through, and a flat brim that rests against the areola. Some shields have a cutout section in the brim to allow more skin-to-skin contact between your baby's nose or chin and your breast during feeds.
The shield works by providing a slightly firmer, more protruding surface than the natural nipple alone. For babies who struggle to latch — whether due to prematurity, tongue-tie, flat nipples, or simple preference after bottle-feeding — the shield can make the difference between breast refusal and a successful feed.
When a Shield May Help
Flat or inverted nipples: When the nipple doesn't protrude enough for the baby to create a good seal, the shield's dome provides the shape the baby needs. This is one of the most common and well-supported reasons for shield use.
Premature babies: Preterm infants often have a weaker suck and less stamina. The shield's firmer surface can help them maintain a latch they might otherwise lose. This is widely used in NICUs as a bridge to direct breastfeeding.
Tongue-tie (before or after revision): A tongue-tie restricts the tongue's range of motion, making it harder for the baby to create proper suction. A shield can compensate temporarily — especially in the recovery period after a frenotomy (tongue-tie release).
Latch refusal or bottle preference: Babies who were bottle-fed early may prefer the firmer, more consistent shape of a bottle nipple. A shield can act as a transitional surface to help the baby re-learn breast-feeding. The La Leche League International offers additional resources on managing bottle-to-breast transitions.
Nipple damage recovery: When nipples are cracked or damaged, direct breastfeeding can be extremely painful. A shield creates a barrier that reduces friction during feeds while the tissue recovers. However, the shield should be paired with identifying and correcting whatever caused the damage in the first place — usually a latch or positioning issue.
Choosing the Right Size
Size matters more than brand. Nipple shields generally come in three sizes based on nipple base diameter (measured across the widest part of the nipple where it meets the areola, not the areola itself).
| Size | Nipple Base Diameter | Fit Notes |
|---|---|---|
| Small (16mm) | Under 16mm | Less common — check with LC to confirm fit |
| Medium (20mm) | 17–20mm | Most commonly fitted size |
| Large (24mm) | Over 20mm | For larger nipple bases |
Signs the shield is too small: Your nipple rubs against the sides of the dome, causing pain. Milk flow feels restricted. The shield feels tight or compressed.
Signs the shield is too large: The shield slips or won't stay in place. Your baby can't maintain a seal, resulting in clicking sounds, air swallowing, or milk leaking around the edges.
Signs it fits correctly: Your nipple enters the dome freely with a small gap at the tip. The brim sits flat against your areola. Your baby latches comfortably with lips flanged over the brim (not just the dome). You feel a deep, rhythmic pulling sensation — not pinching.
How to Apply a Nipple Shield: Step by Step
Step 1 — Wash your hands. Clean hands reduce the risk of introducing bacteria to the shield surface and your breast.
Step 2 — Moisten the rim. Apply a few drops of expressed breast milk or warm water to the inner rim and the tip of the shield. This improves the seal against your skin, reduces friction, and the scent of breast milk on the tip encourages your baby to latch.
Step 3 — Partially invert the brim. Hold the shield by its edges and turn the brim partially inside out (about halfway). This is the key step — when you release it over your nipple, the brim will spring back into position, creating gentle suction that draws your nipple into the dome and holds the shield in place.
Step 4 — Center over your nipple and release. Position the dome directly over your nipple and let the brim flatten against your areola. If your shield has a cutout section, orient it where your baby's nose or chin will touch your breast for skin-to-skin contact.
Step 5 — Latch your baby. Tickle your baby's upper lip with the shield tip. Wait for a wide-open mouth. Guide your baby onto the shield chin-first, then direct the dome toward the roof of their mouth. Your baby's lips should flange over the brim of the shield — not just the dome. You should feel a deep, rhythmic pull, not a pinching or biting sensation.
Step 6 — After the feed. Gently break the suction with your finger before removing the shield. Rinse with warm water and allow to air dry. For guidelines on safe breastfeeding practices, the CDC provides current recommendations.
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View DetailsSigns It's Working — and Signs It Isn't
A nipple shield should make breastfeeding easier, not harder. Monitor these indicators at every feed:
Signs it's working: Your baby latches more easily and stays latched longer. You hear rhythmic swallowing sounds during the feed. Your baby is calm and satisfied after feeding. Diaper output is on track — at least 6 wet diapers and 3 yellow stools per day after the first week. Your baby is gaining weight at their expected rate (typically 150–200g per week in the early months).
Signs it isn't working: Your baby repeatedly breaks the latch, clicks, or fusses during feeds. You see milk leaking around the shield edges (poor seal). Diaper output drops. Your baby seems unsatisfied or feeds for very long stretches without the signs of swallowing. Your nipple is compressed, blanched, or painful when you remove the shield. Weight gain slows.
Weaning Off the Shield
Nipple shields are designed to be temporary. The goal is to transition to direct breastfeeding when the underlying issue resolves — whether that's your baby growing stronger (in the case of prematurity), latch improvement after tongue-tie revision, or your nipples recovering from damage.
Gradual approach: Start a feed with the shield, then remove it mid-feed once your baby has settled into a good rhythm and your let-down has started. Many babies accept the bare breast more easily when milk is already flowing. If your baby protests, reapply the shield and try again at the next feed.
Skin-to-skin sessions: Regular skin-to-skin time outside of feeding builds your baby's comfort with your breast. Offering the bare breast during drowsy feeds (when the baby is less alert and more instinctive) often works better than attempting during full-alert hungry cries.
Don't rush. Some babies wean off quickly; others need weeks. Forcing the transition creates negative associations with the breast, which is counterproductive. Work at your baby's pace with your lactation consultant's guidance. The Academy of Breastfeeding Medicine protocols provide clinical guidance on weaning strategies.
Shields vs. Silver Cups: Different Tools
Nipple Shield
When: During feeds only.
Purpose: Helps baby latch onto the breast.
Material: Thin medical-grade silicone.
Duration: Temporary — wean off when latch improves.
Key point: Requires professional fitting and monitoring.
Silver Nursing Cups
When: Between feeds.
Purpose: Reduces friction from clothing, antimicrobial surface contact.
Material: 925 Sterling or 999 Fine Silver.
Duration: As long as you're breastfeeding — ongoing comfort tool.
Key point: Not a latch device. Not used during feeds.
These tools are complementary, not interchangeable. Many mothers who use a nipple shield during feeds also use silver nursing cups between feeds — the shield manages the latch challenge, while the cups reduce friction and provide a smooth, antimicrobial surface for sensitive or recovering nipples between sessions.
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View DetailsCleaning and Care
After every feed: Rinse the shield with warm water. No soap is needed between feeds — warm water removes milk residue without leaving fragrance or residue that could deter your baby from latching.
Once daily: Wash with warm water and a small amount of unscented dish soap. Rinse thoroughly and air dry on a clean surface. Sterilization (boiling for 5 minutes or using a steam sterilizer) should be done once daily, especially in the first few months when your baby's immune system is developing.
Storage: Keep the shield in a clean, ventilated case between feeds. Avoid sealing it in a zip-lock bag while still damp — trapped moisture encourages bacterial growth.
Replace regularly: Inspect the shield before each use for tears, thinning, or discoloration. Replace it at the first sign of damage. Even without visible wear, consider replacing every 4–6 weeks of regular use — silicone degrades with repeated heating and sterilization. The Mayo Clinic provides additional guidance on maintaining breastfeeding equipment.
📋 Editorial Note & Transparency
Medical Disclaimer: This content is educational and does not constitute medical advice. Nipple shield use should be guided by a qualified lactation consultant (IBCLC) who can assess your specific situation, ensure correct sizing, and monitor your baby's milk intake and weight gain.
Product Disclosure: Go Mommy manufactures the Silver Nursing Cups featured in this article. Go Mommy does not manufacture nipple shields. Information about nipple shields is based on published clinical guidelines, peer-reviewed research, and professional lactation guidance.
Sources: Guidance references the AAP, ABM, CDC, La Leche League, Mayo Clinic, NHS, and OWH.
Last reviewed: March 2026 · Content by Go Mommy editorial team
Frequently Asked Questions
How do I know if I need a nipple shield?
A lactation consultant should make this assessment. Common situations include flat or inverted nipples, premature babies with weak suck, tongue-tie, bottle-to-breast transition, and nipple damage that makes direct feeding painful. A shield is rarely the first intervention tried.
How do I measure for a nipple shield?
Measure your nipple base diameter — the widest point where the nipple meets the areola. Under 16mm typically needs a small shield, 17–20mm needs medium (most common), and over 20mm needs large. Your lactation consultant can help with accurate measurement.
Will a nipple shield reduce my milk supply?
Older studies with thick rubber shields showed reduced milk transfer. Modern thin-silicone shields perform better, but the risk isn't zero. Monitor your baby's weight gain and diaper output weekly. If supply drops, consult your LC — pumping after shielded feeds can help maintain production.
How long will I need to use a nipple shield?
Most families use them for a few weeks to about 6 weeks. Some need them longer, particularly with premature infants. There's no fixed deadline — work with your LC to wean off gradually when your baby's latch improves.
My shield keeps slipping off. What am I doing wrong?
The most common cause is skipping the partial inversion step. Turn the brim halfway inside out before placing it, then release over the nipple — this creates gentle suction. Also moisten the rim with breast milk. If it still slips, the size may be wrong — too large causes poor seal.
What's the difference between a nipple shield and silver nursing cups?
Completely different tools. A nipple shield is silicone, worn during feeds, and helps the baby latch. Silver nursing cups are metal, worn between feeds, and reduce friction from clothing on sensitive nipples. Many mothers use both — the shield during feeds, cups between feeds.