I'm a little suprirsed I only saw one reply about the Madela nipple shield. I can't speak personally about the Avent shield, but I was able to successfully breastfeed during those incredibly painful times, or even use a breast bump with the shield, and it was wonderful! It's like a very thin layer that you express just a little milk so that it sticks over and has holes in it for the milk flow through. It helps with both the pain and healing because it keeps the wounds covered. Wonderful, wonderful invention, imho.