Nipple shield size

What size of nipple shield should I use?

Nipple shields are classified by the width of the base of the cone and are usually available in widths of 16, 20, and 24 millimetres. Use the largest nipple shield that the baby can comfortably handle. Most full-term babies and their mothers do best with a 24-mm nipple shield. Generally, 20-mm nipple shields are recommended only for small premature babies and 16-mm nipple shields for very small premature babies. The smaller the nipple shield, the higher the risk of nipple pain and of the baby not getting enough milk. Some mothers with very large nipples need 28-mm nipple shields.  

A) Describing sizes

A regular-style 24-mm nipple shield

Nipple shields are classified by the width of the base of the cone. They are commonly available in 16-, 20-, and 24-millimetre sizes but 28-mm nipple shields may need to be ordered online.  

If you are unsure of the size of the nipple shield, look at the rim, since the size is often written there. Alternatively, you can measure across the bottom of the cone.

Nipple shields come in several styles. The style is a matter of personal preference, but cone size has a big impact on how well the nipple shield works.

B) Choosing the size

The nipple shield size is usually based on the size of the baby’s mouth. Most full-term babies and mothers do best with the 24-mm nipple shield. It may seem large, but see how the baby responds to it before trying a smaller one. The smaller the nipple shield, the higher the risk of nipple pain and of the baby not getting enough milk.

In general, 20-mm nipple shields are recommended only for premature babies, but a few full-term babies do better with a 20-mm nipple shield than the standard 24-mm nipple shield. The 16-mm nipple shield is generally recommended only for very small premature babies.

Mothers with very large nipples may need a 28-mm nipple shield to increase the amount of milk the baby gets and to reduce nipple pain. They may not be able to use a smaller nipple shield.

C) The appearance of the nipple in the nipple shield

Mothers often worry that their nipple does not fill the nipple shield. That is normal. There is nearly always a gap between the nipple face and the tip of the cone.

If the nipple totally fills the cone, the nipple shield may be too small. If the nipple can touch the tip of the nipple shield cone, mothers may experience pain. 

D) Different cone shapes

Different manufacturers will make slightly different cone shapes with some being more like a cone and others closer to a cylinder. We prefer the former as we have found babies are less likely to clamp on the shield tip and pinch the nipple.