Supplemental nursing system
Alternative feeding methods – Transcript
Many breastfeeding mothers find that at times there may be a need to give a supplement of milk to their baby (MIXED FEEDING)and if that is you, it could be for a number of reasons. It might be that your baby hasn’t latched at all from birth, (baby not latching)and you are now pumping your milk, and needing to offer a supplement that way. Sometimes it’s simply that babies are not feeding well at the breast, and therefore not getting as much as (he) needs. You have to pump your milk, (as well as) breastfeeding and give your baby that supplement.
Another scenario could be your baby has just gone on a nursing strike where he refuses the breast suddenly, out of the blue, when he’s a few months old. This can go on for a few days, and of course there is a need to be able to give your baby milk during that time – and although it can be tempting to think that formula is the best option to give as a supplement, always bear in mind that your OWN breast milk is the priority supplement. So where there is opportunity to pump your milk and give that as the extra milk, all the better.
I do appreciate that this sometimes isn’t possible, and it might be that your body isn’t making that milk at the moment or able to make that milk (other causes of low supply)– but always keep in mind your own breast milk as the priority.
I do understand that a lot of breastfeeding mothers will consider using a bottle as the only way to give supplements, as it seems to be etched into our psyche that that has to be the vehicle – but we do know that in the first few weeks – maybe four, five, six weeks, your baby is learning how to breastfeed at the breast, and sometimes the bottle can cause unnecessary confusion to the baby.
And please bear in mind that when babies feed from a bottle, they get instant access to milk without having to work too hard – that milk just keeps flowing out, and at the breast it’s a different matter. It is a different suction technique. Normal biology is that baby is feeding fast at first, fast sucks to call the let-down, and then they swallow milk (so they are more rhythmically swallowing), and then they settle down a little bit, pause a bit, then they call down more milk, and so the pattern of feeding changes a lot.
And we often find that babies who are having bottles will then 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 it would be very good for you to have a look at the video relating to how to offer that bottle in a breastfeeding friendly way, responsive bottle feeding, to give you some hints and tips about that.
But in the first instance, think about some alternative methods of giving that milk. So what are those alternatives? Now if your baby has been recently born, in those first few weeks it’s possible that you could think about using a cup – a very small, medicinal type of cup that babies can lap from. We don’t want your baby to be gulping that milk down, but babies can lap the milk like a kitten.
Although some of the studies are mixed around cup feeding there are some that have shown that babies are less likely to get nipple confused and more likely to be able to successfully breastfeed, and some studies have shown that premature babies have maintained much more stable oxygen levels when they are cup feeding, as opposed to bottle feeding.
So this technique of cup feeding involves using a small cup that’s really a shot glass size or medicine type cup. It can be flexible like a medicine cup but it’s really only holding maybe about 30 to 60 mls of milk – and you are only going to fill it half full. Your baby is going to be upright, near to you, upright – not tipped back. You may wish to put a little bib underneath your baby or a small towel to stop the drips, half fill the glass and bring it to baby’s lips – just tipping it enough to allow your baby to feel that milk, and then your baby will lap it like a cat or a little kitten – and that’s what you would expect your baby to do. But really, you’re putting your baby in control, and letting your baby lap that at his own pace.
And you can also give supplements to your baby using a spoon, so small amounts of milk on the spoon, bringing the spoon to your baby’s lips, just letting your baby lap that milk from the spoon. Once again, your baby is in control – and remember to keep a little blanket around you baby, just to keep baby’s arms out of the way. That can be useful.
And your baby can also be given a supplement of milk by using an eye dropper, once again in the same way, allowing your baby to be upright on your knee. Just dropping that milk into his mouth very carefully.
A feeding syringe can also be used which is just an opportunity to give more of that milk in a very similar way too, and it might be that your baby is feeding at the breast but not feeding efficiently enough – and you want to give that extra supplement but still to keep him feeding at the breast. So you can use one of these feeding syringes while he is actually there. You can insert the tip of the feeding syringe into his mouth, while he is attached, depress the plunger of the syringe, and he will get that milk as he’s starts to suckle.
If your baby is requiring extra supplements of milk for many weeks then you may wish to consider using a supplemental nursing system or a Lactaid. This is a device which can allow your baby to feed at the breast (and your baby must be able to latch in order to use this device) – but this will enable your baby to get extra milk, that extra supplement, preferably of your own milk or formula, while he is also stimulating your supply.
Circumstances which may lead you to use these devices can be varied really. It might be that you are inducing lactation for an adopted baby or relactating, and you want to keep all that sucking at the breast as you start to build up that supply again.
It may be that you are just not able to produce that milk no matter what you do, because of (maybe) a medical condition – and so you want that baby at the breast, and you want to be able to have that closeness of breastfeeding and giving that supplement while he’s there, and still be able to give some of your milk, even if it’s only minimal amount.
So there can be other reasons too – but it can be a very effective device. So how does it work? A container for the milk, which is 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, and you can secure that with tape on both sides, and when your baby latches onto the breast he’s also going to take the tubing into his mouth, as well as latching on – and when he sucks, he gets the supplement along with milk from your breast too – and that sucking is going to help to stimulate your supply, and the supplement will then reward him for sucking properly.
If your baby is not yet latching at the breast, then the supplemental nursing systems are not viable. But what you can do is use an alternative feeding method called finger feeding, and this involves using a nursing supplementer, which basically attaches by a tape,securely – those little tubings, attached to your finger. You can then insert your finger into the baby’s mouth very carefully. This can help your baby to learn how to suckle, also getting that reward of that milk from the supplementer.
And 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.
And I really think it’s wonderful that there are many more feeding devices available now on the market. There is a device called a Haberman Feeder which can be useful for babies who have maybe a receding jaw or cleft lip and palate. Babies that require that little bit of extra control to enable them to progress with feeding.
I would however strongly recommend that you seek out skilled support from an IBCLC or breastfeeding counsellor, somebody who understands about nursing supplementers, but also and more importantly can look at all of the issues that have led you to think about using such a device.
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Version 1.1 published in March 2019. Next review date: Jan 2022
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