If there are problems using a nipple shield, they will develop soon after starting to use one.
Accordingly, every mother and baby should be seen by their health-care providers when starting to use a nipple shield and again within a few days to ensure the baby is getting enough milk and not showing signs of being underfed. A further visit should take place within two weeks.
Assessing milk intake in a newborn who is using a nipple shield before the mother’s milk is in is be more difficult. These babies need close monitoring as they can quickly become sleepy and underfed and their mothers should express after all feeds until the milk comes in in order to establish a food milk supply.
Premature babies also need close monitoring as they grow and develop their breastfeeding skills.