Lactation Consultant Mary Dowswell

19/11/2025

This is a visual display of oral ties. If a health provider just has a look at your baby/child but does not do a functional assessment (that is, putting their gloved fingers in your baby’s mouth) you need a second opinion, especially if there are feeding challenges.

https://www.researchgate.net/figure/Neonatal-Tongue-Sreening-TEST-Martinelli-27_fig1_331328592

07/08/2025

Thank you and for the mention. It is an honour to continue helping mothers and babies with their breastfeeding journey. Please feel free to reach out

07/08/2025

https://mungbeanhealth.com/blogs/blog-page/world-breastfeeding-week-honouring-the-real-raw-remarkable-stories-of-our-mungbean-mamas?fbclid=PAQ0xDSwMBQ91leHRuA2FlbQIxMAABp1L-nTuXBrPUKP7nihqZU8dJO136cwPeEmPL6bS30vTwB2LAyBT46dA5ZjH2_aem_Z5DvHxtHLsWE1882QtC2RA

This World Breastfeeding Week, we’re creating a space where every story is welcome, the joyful, the challenging, and everything in between. It’s about honouring every journey and deepening our connection as a community through shared support and understanding. At Mungbean Health, we believe that...

24/07/2025

Vasospasm is a painful condition related to changes in blood flow. There are many treatments available but a sub optimal latch can make it worse. Reach out if you need an assessment.

24/07/2025

Vasospasm, what is it? The ni**le can blanch and it can also be painful, but you can also have one or the other or both. Vasospasm may be more common in those with a history of Raynaud’s phenomenon of the fingers. Secondary vasospasm may occur following trauma to the ni**les. Persistent vasospasm can result in a cycle that potentiates trauma, due to vasoconstriction and inability to heal in the setting of chronic alterations in blood flow. Mammary blood vessels are exquisitely sensitive to epinephrine and norepinephrine.

Treatments: Breast warmers, correcting latch, investigating if there is tongue tie in baby, vitamin B6, essential fatty acids, magnesium, SSRI class drugs, e.g. Sertraline, osteopathy with exercises.

Often mistaken for thrush due to the burning pain.

Reach out if you feel you are experiencing this. A thorough assessment by an IBCLC is needed.

Send a message to learn more

13/04/2025

Exciting news!

Starting next month, our Bowral clinic will move into its very own dedicated space within Springett’s Arcade. This new location will allows us to offer more days and opens up exciting opportunities for future growth.

We can’t wait to welcome you into our new space! Stay tuned for updates and come visit us soon.

Starting next month, our Bowral clinic will move into its very own dedicated space within Springett’s Arcade. This new location will allow us to offer more days and opens up exciting opportunities for future growth.

30/03/2025

Have you ever used a ni**le shield in your breastfeeding journey? I feel ni**le shields are not always used appropriately or nurse/midwives or other lactation consultants advise not to use them. Many shields are given out when babies are just born (for reduced ni**le length and size or erectile function). Have a read of the research and make up your own mind... I on the other hand, recommend their use in a baby that is having difficulty latching due to tongue tie or a smaller prem baby that is tiring to keep a hold of the ni**le and keeps coming off the breast. Nevertheless, it is still controversial.

https://pubmed.ncbi.nlm.nih.gov/33305973/

https://pubmed.ncbi.nlm.nih.gov/33443588/

https://www.facebook.com/DrGhaheriMD/photos/a.451553228339392/2167056970122334/

Stop Being Anti-Ni**le Shield

I’m perplexed at the number of professionals who are categorically against the use of ni**le shields. I hear things like:
“Ni**le shields don’t work”
“Ni**le shields will confuse the baby”
“Ni**le shields will ruin your milk supply”

Huh?

Let’s review a few studies:
1) Hanna et al (2013) - “A description of breast-feeding outcomes among U.S. mothers using ni**le shields.”This longitudinal study looked at 81 postpartum mothers who used shields. 72% of moms reported that the shields were “extremely helpful”. The authors concluded that shields can help moms who may otherwise abandon breastfeeding. While the study isn’t controlled, it is helpful to see that moms can use the shield and eventually wean off.
2) Kronborg et al (2016) - “Why do mothers use ni**le shields and how does this influence duration of exclusive breastfeeding?” This is a larger study of 4815 Danish mothers who self-reported information regarding ni**le shield use. First time moms were more likely to use shields as were moms of babies with lower gestational age or birthweight. Some moms were helped and others became dependent on its use. There was a 3x increased rate of stopping breastfeeding if the shield was used - this is an important point we’ll discuss below.
3) Meier et al (2000) - “Ni**le Shields for Preterm Infants: Effect on Milk Transfer and Duration of Breastfeeding” - This study looked at 34 preemies and compared feedings with and without the shield. These babies consumed more milk with the shield than without. The authors didn’t find a correlation between ni**le shield use and a shorter duration of breastfeeding.

There are more studies. But I chose these to make a few points. Ni**le shields have the capacity to help. They also have the capacity to contribute to prematurely terminating the breastfeeding relationship. There are definitely instances where they become needed - severe ni**le pain and an inability for the baby to latch on at all are the most prevalent in my experience. There is evidence that shield use can help a mom hang on until she can be supported.

My thoughts:
1) The use of ni**le shields should not be condemned. What *SHOULD* be condemned is the use of a ni**le shield as a permanent solution to breastfeeding symptoms. What *SHOULD* be condemned is the distribution of the ni**le shield to moms immediately in the hospital by a nurse, physician, unit secretary, custodian, friend, family member, etc (this seems to be the case now, where anyone can hand out a shield). The only time a shield should be used is under the guidance of a lactation consultant. More importantly, the use of the shield needs to be followed because I'm convinced that the moms who end nursing early because of shield use don't do it because of the shield, but rather that their breastfeeding is so poor that even the shield doesn't help them. Someone needs to figure out why.
2) The ongoing need to use the ni**le shield means that you need to investigate the oral anatomy of the baby. In my world, the need to use the shield beyond 4-6 weeks indicates a higher likelihood of tongue tie.
3) Just because you have flat ni**le does NOT mean you need a shield. Remember, flat ni**led moms made it through evolution without shields. I would argue that a flat ni**led mom who has a tongue tied baby has a higher chance of needing the shield. If the baby is dependent on using the lips instead of the tongue (a common compensation), then shield use becomes more common because the baby is turning the breast into a straw.

Investigate WHY you need the shield.
Don’t be afraid to use the shield as a crutch. It’s a temporizing measure to get things to settle down.
It’s a tool. It’s not a plan. If you tore your ACL but your surgeon told you to just keep using crutches, you’d balk. This is no different.

30/03/2025

Ni**le shields apparently have been around for a very long time. These pictured are circa 1700's. Now I would think not much stimulation was happening with these shields, the one the right, I would imagine was for flat ni**les or to allow baby to suckle easier. Today ni**le shields are made of silicon, of varying thicknesses and sizes. Many health professional advise not to use ni**le shields or advise mothers to stop using them. They think they reduce flow, reduce stimulation or reduce milk supply. Did you know there is some great RCTs (Random Controlled Trials) evidence that disputes this! I have found ni**le shields are highly effective in a baby that has oral ties (notably, tongue tie), the shield acts as a splint to allow the ni**le to be drawn into the shield. Also, they are great when there is temporary ni**le damage or pain. If ni**le pain continues post 2 weeks post birth, this needs to be investigated. Essentially, they should not be just given out when the baby is born as there are many factors to consider. I like to say I would prefer a more ideal feed with the shields on, then a less optimal feed without. The evidence supports this. Please see my page for the evidence and for further info. Image credit: https://commons.wikimedia.org/wiki/File:Sterling_silver,_ivory_and_glass_ni**le-shield_Wellcome_L0035701.jpg

20/03/2025

20/03/2025

Mastitis can be scary and you can become very unwell quickly. The guidelines changed nearly 3 years ago but I feel it is still poorly managed by some medical professionals. Managing it appropriately is optimal. Mastitis is not always infective. Abscesses are quite rare but they can still happen. Taking the right antibiotics is also important. Having some therapeutic ultrasound from a physiotherapist or osteopath can also assist. Taking a daily probiotic that has lactobacillus fermentum in it, can be helpful. Also if blocked ducts are occurring often, you may try lecithin, if you are avoiding soy remember to opt for a sunflower type lecithin.

https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/36-mitchell-et-al-2022-academy-of-breastfeeding-medicine-clinical-protocol-36-the-mastitis-spectrum-revised-2022.pdf

https://doulacare.ie/blog/new-guidelines-on-treatment-of-mastitis-and-blocked-ducts

Why have the guidelines changed? There are always new studies happening to improve our understanding of medical care and aiming to improve outcomes. Recently the Academy of Breastfeeding Medicine released "Clinical Protocol #36: The Mastitis Spectrum, Revised 2022" with updated gui

15/03/2025

Reflux in infants. Can be upsetting to see as a parent. Some may say your baby is a "happy chucker!". It is rare to have true acidic reflux in infants. Therefore, proton pump inhibitors (e.g. Pantoprazole-Losec) are over prescribed. Please visit my page for the research. Photo credit: https://www.flickr.com/photos/ragesoss/