Literature review for - Flourish Paediatrics

Nipple Shield Use
Search results
The initial search of the databases included 34 references on nipple shields use during
breastfeeding. The detailed search is included in a separate document on searches. Data
were extracted from one high quality systematic literature review which was used to form a
body of evidence statement on the effects of nipple shield use on breastfeeding outcomes.
EFFECT OF NIPPLE SHIELD USE ON BREASTFEEDING OUTCOMES
What is the physiological response to nipple shield use?
Draft Evidence statement
Draft Grade
Component Rating Notes
Nipple shield use is associated with a decrease in milk
transfer however more research investigating this
association is required
D
Evidence Base Poor 1 SLR (P) on 13 studies (3 studies investigated the
physiological response to nipple shield use). All three
studies had small sample sizes.
Consistency
Satisfactory All three studies demonstrated nipple shield use was
associated with a decrease in milk transfer
Clinical impact Poor Larger studies are required to evaluate the effect of
nipple shield use on breastfeeding duration
Generalisability
Applicability
Satisfactory SLR conducted in US. Country where each study was
conducted is poorly defined.
Satisfactory Results are applicable to Australian women
The systematic literature review conducted in 2010 searched the database for articles
published between 1980 and 2009 on the use of nipple shields during breastfeeding
(McKechnie and Eglash 2010). The authors investigated 13 articles for detailed review. No
high-quality studies have been conducted on nipple shield use since this review.
The review included 3 studies on physiological responses to nipple shield use. All three
studies demonstrated nipple shield use was associated with a decrease in milk transfer
however the studies had small sample sizes. One well-designed study compared a group of
mother’s breastfeeding without a nipple shield (n=16) with a group of mothers’ breastfeeding
with a nipple shield (n=16). The median milk transfer to infants in the group without a nipple
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