Thursday, March 5, 2015

Using a SNS to Save (or Create) a Breastfeeding Relationship

by Glenni Lorick, IBCLC

Did you know that adoptive mothers can nurse? And mothers who have problems with supply can nurse? And mothers who have premature babies with very week sucks can breastfeed? In fact, any woman who wants to breastfeed her baby can do so with an amazing device called a Supplemental Nursing System.

A mother can put formula, donor breast milk or her own milk in the bottle and attach the two tubes to the breast right at the nipple using paper tape (included with the SNS). The tubing can be closed off via a slit in the cap so that no milk will flow until it is released.

When the baby latches on and begins to suck, the mother can release the tubing allowing the supplement to flow. The specific method of use depends upon the mother's own milk supply, the baby's condition, and the reasons she is using the SNS.

Preemie or Special Needs Baby

The mother of a Premature or special needs baby will not be able to rely on her baby to establish a good milk supply. She will need to pump frequently in the early days (8-12 times a day for the first 4 days) in order to create an abundance of prolactin receptors on each milk gland. Once milk comes in, she will need to continue to pump at least 8 times a day for the next few weeks. Most exclusively pumping moms find that they settle into a routine of pumping 5-8 times a day by the time baby is a few weeks old. The SNS will allow mom to feed the pumped milk directly at the breast. Although the baby's suckling may produce some stimulation, it will not be sufficient at first. As a premature baby grows and gets stronger, his mother will find herself having to pump less and less for stimulation. Usually premature babies can wean off the SNS around the time of their actual due date or shortly thereafter.

When a premature baby first begins to feed with the SNS, mom needs to have the flow open from the beginning. Premature babies can burn a lot of calories nursing - valuable calories that they need to grow. The SNS (or a similar product like the Lact-Aid) makes it much easier to get the milk needed with much less effort. As baby grows, Mom can begin the feed with the tubing closed, then open it as the feed progresses and baby stops actively sucking and swallowing.

Infants with special needs like a cleft lip, Down Syndrome or any other condition that makes suckling difficult or ineffective may be able still have a breastfeeding relationship using the SNS. It truly varies from baby to baby, and a mother with a special needs baby really needs to work closely with an International Board Certified Lactation Consultant (IBCLC).

Mom with a Low Milk Supply

The SNS is a true blessing for mothers who struggle with milk supply because it allows the mother to supplement the baby right at her breast. This is vital because the active suckling of the baby actually helps stimulate Mom to make more milk.  Instead of nursing, then supplementing with a bottle if baby isn't getting enough, the SNS allows the entire feeding to happen at the breast. Whether her low supply is due to breast surgery, hypoplastic breasts, PCOS or any other condition, the SNS can help any mother feed her baby entirely at the breast.

If a mother is struggling with supply she needs to begin the feed with the SNS closed. I recommend nursing on one breast until baby stops actively sucking and swallowing, then switching to the other breast with the SNS still closed. After baby has nursed on both breasts and is no longer swallowing, return to the first breast, but open the SNS so that baby receives the supplement flowing through the tube as he nurses. This will help the baby to continue actively sucking and swallowing and actually enable him to suck deeply enough to receive some of the hind milk. It is up to Mom whether he needs to burp and switch sides again. But if he is getting more than 1 oz. of supplement, it is a really good idea to split it between the two breasts so that he is nursing 2 times on each breast
From the San Diego Breastfeeding Center. 
Photo: Barbara Robertson, IBCLC

Adoptive Moms

Just because you didn't conceive and give birth to your baby doesn't mean that you can't breastfeed him! In fact, some adoptive mothers even begin to make breastmilk by following this protocol set forth by Dr. Jack Newman. The SNS is an integral part of adoptive breastfeeding. Some adoptive mothers are able to obtain breast milk from a donor or a milk bank. NEVER pay for breast milk from an individual. If you do choose to use a donor, make sure it is someone you know and trust.

An adoptive mother will set up the SNS tubing on both breasts and begin the feed with the tube open so that baby will receive milk throughout the feed. In fact, the SNS actually helps stimulate her body to make milk. Generally, however, adoptive moms do end up needing the SNS for all feedings. is

Whether a mother is using it short term or long term. with a premature baby, a special needs baby or an adoptive baby, the fact is that a SNS is a true Godsend for the mom who cannot otherwise have a fulfilling breastfeeding relationship.

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