Supplemental nursing system
Alternative feeding methods
If you are hoping to breastfeed or you are currently breastfeeding, there may be several specific scenarios that may require you to give a supplement of milk to your baby.
It could be that your baby hasn’t latched at all from birth, and you are now pumping your milk, and need to offer supplements of your expressed milk.
Sometimes it may simply be that your baby isn’t feeding well at the breast, and therefore not getting as much milk as he needs.
In these situations, you may need to pump your milk, as well as breastfeeding, and offer your baby more milk via a supplement too.
Another scenario could be if your baby suddenly refuses to latch on and feed at the breast, which is known as a nursing strike, and usually happens when babies are a few months old.
The nursing strike may last for a few days and can be very distressing for both mother and baby.
During this time, you would need to offer your expressed breast milk instead.
Although it can be tempting to think that formula is the best option to give as a supplement, always bear in mind that your breast milk is the priority supplement, so where there is an opportunity to pump your milk and give that as the supplement, all the better.
Lots of breastfeeding mothers prefer to offer a bottle to give their baby the supplement.
Bottle feeding has been etched into our psyche for decades now, and we have often never considered that there are alternative ways to feed our babies.
Using a bottle in the first few weeks after the birth of your baby as he is learning to breastfeed could cause unnecessary confusion to the baby.
When babies feed from a bottle, they get instant access to milk without having to work too hard.
The milk keeps flowing out! At the breast, the pattern is quite different.
There is also a very different sucking technique.
From a biological standpoint, at the breast, babies initially do fast sucks.
These fast sucks’ call’ the milk down, known as the let-down, and then your baby swallows this milk (a slower, more rhythmic pattern).
He may then pause for a while, doing small, fluttering sucks.
After a while, another let-down occurs, and so the pattern of feeding progresses.
Often, babies who are having bottles become fussy at the breast as the flow starts to slow, because they’re not used to that.
So if you are offering a bottle, you might find it useful to consider offering the bottle in a safe, breastfeeding-friendly way.
However, before deciding how to offer your baby a supplement, you may wish to think about alternative methods.
So what are those alternatives?
If you have only recently given birth, it’s possible to offer your baby milk via a small, flexible medicine cup, or even an egg cup.
Although there are mixed studies around the benefits of cup feeding, some have shown that babies are less likely to get nipple confusion and more likely to be able to breastfeed, if fed via a cup.
Other studies have shown that premature babies maintain much more stable oxygen levels when they are cup fed, as opposed to bottle-fed.
So what is the technique?
The cup will usually only be able to hold about 30 to 60ml of milk, and you only need to fill it half full.
Your baby needs to be semi-upright, near to you, and not lying down.
You may wish to use a little bib or a small towel to stop the drips.
Bring the cup to your baby’s lips. It’s important to tip it just enough to allow your baby to feel the milk.
He will then lap it like a cat or a little kitten. Ultimately you are putting your baby in control of the flow of milk, and letting him lap it at his own pace.
You can also give supplements using a spoon. Offer small amounts of milk on the spoon, bringing the spoon to your baby’s lips, once again, just letting him lap the milk, and putting him in control.
It can be useful to use a small blanket to keep his arms out of the way, as some babies wave their arms around and cause milk to spill.
An eyedropper is another method you can use to give your baby a supplement of milk.
In the same way, keep your baby upright on your knee, and drop the milk into his mouth very carefully.
Another way to give supplements is to use a feeding syringe.
If your baby is feeding at the breast, but not particularly efficiently, you can use a feeding syringe while he is at the breast.
Insert the tip of the feeding syringe into his mouth while he is attached, depress the plunger of the syringe, and he will receive milk as he starts to suckle.
If your baby requires extra supplements of milk for many weeks, then consider using a nursing supplementer, which is a device that can allow your baby to feed at the breast.
Your baby must be able to latch to use this device, and it will enable him to receive the extra supplement of milk, i.e., your breast milk, or formula, while he is also stimulating your supply.
Circumstances which may lead you to use these devices can vary, e.g inducing lactation for an adopted baby, or relactating.
Using this device will enable you to keep all the sucking at the breast, and can help to build up your supply at the same time, while your baby receives as much milk as he needs, i.e., a combination of breast milk and formula.
It’s possible that because of a medical condition that you have or other underlying factors (despite doing all you can to boost your milk supply), your body is finding it a huge challenge to produce much milk at all.
It could be that you aren’t producing any milk (a condition called Sheehan’s syndrome).
If you do find yourself in the situation, but want to be able to have the closeness of being able to breastfeed your baby, then the nursing supplementer may be an important device to try.
There are different types of nursing supplementers, ranging from homemade ones to commercial ones.
How commercial supplemental nursing systems work
A container for the milk, either a bag or a plastic bottle, hangs from a cord around your neck. Narrow silicon tubing runs from the container to the tip of your nipple.
You can secure that with tape on both breasts. When your baby latches onto the breast, he will also take the tubing into his mouth.
When he sucks, he will receive the supplement along with milk from your breast too.
The sucking will help to stimulate your supply, and the supplement will then reward him for sucking correctly.
If your baby is not yet latching at the breast, the supplemental nursing systems are not a viable option.
You can, however, use an alternative feeding method called finger feeding, which will involve using a nursing supplementer, where you attach the thin tubings via tape to your finger.
You can then insert your finger into your baby’s mouth very carefully.
This can help your baby to learn how to suckle, as he will be rewarded with milk from the supplementer.
It’s also possible to use a feeding syringe for finger feeding. The tip of the syringe can be placed inside your baby’s mouth while he sucks on your finger.
There are other feeding devices available, e.g., The Haberman Feeder can be useful for babies who have a receding jaw or cleft lip and palate, or any baby who requires that little bit of extra control when feeding.
Seek out skilled support from an IBCLC or breastfeeding counselor, and who understands about nursing supplements, who can look at all of the issues that have led you to think about using such a device.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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