Independent thesis Advanced level (professional degree), 10 credits / 15 HE credits
Background: Infants born before 37 gestational weeks are defined as being prematurely born.
Breast milk is considered to be the best nutrition for preterm infants. However, they have an
immature sucking behavior and the capacity for breastfeeding at the breast will likely be
affected. The nipple shield has been used, and still is in some contexts, as a device to help the
immature infant to attach to the breast. Among researchers and health professionals there are
divergent opinions on the benefits and the negative aspects of using nipple shields.
Objective: To explore perceptions and experiences of using a nipple shield among parents
and staff in neonatal units in Sweden and England.
Design: A qualitative study with an ethnographic approach. Observations and interviews were
conducted in four neonatal units in Sweden and England. The data were analyzed using a
thematic analysis and the result was presented in thematic networks.
Result: Two global themes were identified. One theme with parents’ experiences “A tool?”
was identified which include organizing themes; “Technical issues”, “Support from staff” and
“Feeling of something in between”. Technical issues including both how it facilitates and
technical problems when using it. Parents felt confused when they got different advice and
mothers experienced an unnatural feeling when using the nipple shield. Experiences from
staff was summarized in the second global theme; “Contentious tool” with the organizing
themes; “Positive aspects” and “Negative aspects”. The nipple shield can be used as “a
shortcut” to breastfeeding and some used it too easily and others not at all.
Conclusion: This study demonstrates parents’ and staffs’ perceptions of nipple shield both as
a link to help initiating breastfeeding and as a barrier between the mother and infant.
2015.