Nipple shields and extractor? How to use them in mixed breastfeeding
Mixed breastfeeding — that is, the combination of breast milk and formula — can be a practical and emotionally balanced solution for many families. However, their implementation can raise questions, especially about the use of tools such as nipple shields or breast pumps. When should they be used? How can they help or hinder the process? In this article, we explain everything you need to know, with a scientific basis and from an empathetic look at the reality of each mother.
What is mixed breastfeeding and when is it recommended?
Mixed breastfeeding occurs when the baby receives both breast milk and formula. It can be a planned choice from the beginning or a response to situations such as:
- Low milk productions.
- Need for other caregivers to feed the baby.
- Return to work.
- Difficulties in grasping.
According to the Asociación Española de Pediatría (AEP), whenever possible, it is preferable to offer the breast first and then supplement with formula if necessary to maintain stimulation and milk production.
What are nipple shields for?
Nipple shields are silicone covers that are placed over the nipple during feeding. Its use may be indicated in cases such as:
- Painful or bleeding cracks.
- Flat or inverted nipples.
- Premature babies or babies with weak sucking.
- Transition from bottle to breast.
However, their use must be temporary and supervised. A study published in the International Breastfeeding Journal concluded that nipple shields can help at the beginning, but prolonged use can reduce milk transfer and alter the sucking technique (International Breastfeeding Journal, 2021).
How to use nipple shields correctly?
To work and not cause further problems, they must be placed properly:
- Choose a size that fits your nipple size (not your breast).
- Moisten the rim with a few drops of water for extra adherence.
- Center your nipple in the nipple shield tunnel and make sure it moves freely.
- Offer the breast to the baby as usual.
If you notice that your baby is frustrated, not transferring milk, or having discomfort, consult a midwife or lactation consultant.
Nipple shields can be a useful temporary tool, but they require proper placement and supervision.
What about the breast pump? Key in mixed breastfeeding
The breast pump can be your great ally to maintain milk production while introducing bottles with formula. According to the Academy of Breastfeeding Medicine (ABM), pumping regularly is essential to avoid decreased production.
The ideal times to use it are:
- After a feeding, to empty the breast.
- When the baby receives formula and there is no direct stimulus.
- When returning to work.
Ideally, use it at least 6-8 times a day if you want to maintain active production.
"The breast pump helped me to continue offering breast milk despite returning to work. I felt calmer knowing that I was still connected to my baby."
Tips for integrating nipple shields and breast pumps into mixed breastfeeding
There are no one-size-fits-all rules, but these tips can make the transition easier:
- Prioritize the breast: whenever possible, offer the breast before the bottle.
- Pump after feedings if your breast has not been emptied.
- Save breast milk to offer in a bottle, especially if you are separated from the baby.
- Avoid confusion: if you use a bottle, opt for techniques such as the "Kassing method" to imitate the rhythm of the breast.
- Consult professionals if the baby does not gain weight, there is pain or low production.
Choosing a good pump and using it frequently can make all the difference in mixed breastfeeding.
Can it affect the bond with the baby?
A frequent concern is whether the use of devices or the introduction of the bottle affects the mother-baby bond. The answer is clear: no, if skin-to-skin contact, looks, emotional support and connection are maintained during feeding.
Breastfeeding is not only food, but also relationship. And it can be kept alive whether you breastfeed or bottle feed with love, presence, and tenderness.
Consult with professionals