Correctly fitting breast shields are the key to lactation success for pump dependent mothers following preterm delivery

The evidence is now over-whelming that prolonged breastfeeding is one of the most important contributors to child health. However, mothers of preterm infants are vulnerable to lactation failure and need expert intervention if breastfeeding is to succeed. Since many mothers are dependent on manual milk expression for many weeks until their infants are mature enough to establish breastfeeding, effective milk removal is the key to sustaining lactation. Although a hospital grade electric breast pump will provide an effective tool to facilitate the collection of milk, it is essential that the breast shield used is a correct fit. Unless a collection set is used which fits the anatomical configuration of the breast, nipple tissue will rub against the sides of the tunnel causing friction. This may lead to severe nipple excoriation. Milk drainage may also be compromised leading to maternal engorgement and a decrease in milk production. The aim of this article is to ensure that health care professionals who care for preterm infants have an expert knowledge of the principles of milk expression, and the skills to ensure that breast shields are appropriately fitted.