The Impact of Nipple Shields on Breastfeeding Rates, Mother's Milk Volume, Milk Transfer, and Maternal Breastfeeding Self-Efficacy when Breastfeeding the Preterm Infant

Abstract

The purpose of this randomized controlled trial was to examine the impact of nipple shields on breastfeeding outcomes for 32 to 36 week gestation premature infants and their mothers; specifically, as measured by, breastfeeding rates, maternal breastfeeding self-efficacy, milk transfer, and milk volume. Using an experimental pre-post-test design 34 breastfeeding women and their 38 preterm infants were randomized to nipple shields (Users) or no nipple shields (Non-Users). Mothers completed the BSES-SF upon entry to the study, study day seven, and at one month post discharge. Breast milk transfer and maternal milk volumes were measured by mothers for one week. Breast feeding rates were reported at discharge, one month and six months post discharge. Nipple shield Users versus Non-Users demonstrated higher maternal breastfeeding self-efficacy (p = 0.031) on study day seven/discharge, greater milk transfer on study days two and three (p = 0.027,p = 0.030), greater maternal milk volumes on study day six (p = 0.007) and breastfed longer (one monthp = 0.008, six monthsp = 0.027). This study supports the nipple shield as a milk transfer device that has the potential to improve breastfeeding outcomes in preterm infants.