Supplemental Feeding and Alternative Methods
If your doctor or lactation consultant determines that your baby isn't getting enough milk, they will work with you to increase your milk production. Increasing breastfeeding frequency, feeding from both breasts, and expressing your breastmilk with a double pump can all increase your prolactin levels and help you produce a more abundant supply.
There may be situations that require you to use an alternative feeding method for a short time as you build your milk supply. With the goal of exclusive breastfeeding in mind, practice any of these methods cautiously and only under the guidance of a lactation consultant or pediatrician. Alternative feeding should be used on a temporary basis to correct breastfeeding problems. It's not usually a viable long-term solution, and it's important to get your baby back to the breast as soon as possible.
|Cup Feeding||A flexible one- or two-ounce cup is filled with milk and held to baby's lips.||The baby is held upright and allowed to lick at the milk. DO NOT POUR. Baby should not be crying at start.|
|Spoon Feeding||This method is similar to cup feeding but utilizes a spoon. A small, soft spoon is best. Some special spoons hold larger amounts of milk in a reservoir so feeding isn't interrupted.||Tedious and time-consuming but effective.|
|Syringe/Eyedropper Feeding||An eyedropper can be used to drip milk into an upright baby's mouth. A syringe can be used in the same way. A syringe with a long tip can be used to feed at the breast.||Periodontal syringes are best; they have a soft tip that won't hurt baby's gums.|
|Finger Feeding||The tube of a supplemental feeder is held to a clean adult finger. Baby sucks on the finger and gets milk through the tube.||Effective but some babies prefer it to the breast, which can sabotage your breastfeeding success.|
|Supplemental Nursing System||A supplemental nutrition system is used when baby can latch onto the breast but needs supplemental feeding. Typically, a reservoir of milk is worn around the mom's neck and tubes from it are inserted into baby's mouth as she suckles. Baby gets both milks, from the breast and from the system.||Number-one recommended method. Builds Mom's morale. Teaches proper latch on and stimulates milk production.|
|Haberman Feeder||A special bottle with a long nipple and a valve that rewards any level of suckling.||Useful for babies with developmental delays or oral/facial abnormalities.|
|Standard Bottle||Any variety of the plain old infant bottle.||Leads to nipple confusion and poor suck.|
Supplemental nursing systems, like Medela's SNS or Lact-Aid International's Nursing Trainer, consist of a milk reservoir and a short length of very small, clear tubing. The reservoir is worn around a mother's neck from a cord, and the tubing is inserted into the baby's mouth as she nurses at the breast. This technique is the method of choice for most lactation professionals as it allows the breast to be stimulated to increase milk production, helps infants learn proper latch, and preserves the breastfeeding relationship.
Supplementers are used with infants who have a weak suck or nipple confusion from supplemental bottle feeding in the hospital. It's also beneficial for mothers who suffer from a reduced milk supply.
Supplemental nursing system
You can make your own supplementer by cutting a hole in the nipple of a bottle. Add expressed milk or formula to the bottle, and place one end of a small gavage tube (available at medical supply stores) into the hole. Position your baby at your breast in the cradle or football hold. As you support your breast in the C hold, tuck the tube under your thumb, extending it toward the end of your nipple. Latch your baby to both your breast and the tube.
“Nursing is one of the most wonderful things you'll ever do and one of the greatest responsibilities you'll have. You may be giving up some of your own life to provide nourishment, love, and comfort to a tiny human who can't do it for himself, but you're also helping an innocent to grow and thrive and become part of the world.”—Chris
As your infant suckles, she not only receives the milk from the reservoir, but she stimulates and extracts milk from your breast at the same time. Carefully adjust the flow rate to match your baby's ability to keep up. You should be able to hear her swallow milk, but the flow should never be fast enough to cause gagging. Use this method under the guidance of a health care professional.
Cup or Spoon Feeding
Supplemental feeding using a cup can be beneficial for a baby who has jaundice, poor elimination patterns, or inadequate latch. Cup feeding reduces nipple confusion from a bottle and allows the infant to lap milk at her own pace. It can be messy, but it's an easy substitution for breastfeeding. Again, this is only a temporary solution.
To begin, place a towel around your baby or swaddle her in a blanket. Fill a spoon or a soft, flexible cup half full with expressed milk. Bring the cup or spoon to the baby's lower lip. Drip just enough milk into her mouth to taste, and then tip the spoon so your baby can lick the milk. This process is slower than putting baby to the breast, but can be used to supplement breastfeeding as needed. Use of an eyedropper can also be effective.
Finger feeding is hard to learn, awkward, and can cause dependency, but it is useful for babies who have a weak suck, nipple confusion, or neurological problems.
Insert a small gavage tube into the nipple of a baby bottle filled with expressed milk. Place your baby in a semi-reclining position. Offer a clean finger (nail side down) slowly into your baby's mouth, moving it back to the soft palate. If your baby gags, bring your finger forward slightly, and wait until she's comfortable. Place the tube or periodontal syringe next to your finger. As your baby suckles, she will draw milk from the bottle, or you can offer a small squirt from the syringe. Don't try this without first getting the advice of a trained lactation consultant.
“I read the books and felt confident, prepared, and informed about nursing before Katie was born, but doing it was a different story. I sat in the tub and cried. I called a friend who said her biggest regret was not staying with it. Those words motivated me to continue.”—Stephanie
Bottle feeding might be the only alternative available when other techniques don't work. It can be useful for mothers with sore nipples or if an infant can't open her mouth wide enough to latch onto the breast. However, many babies who switch from breast to bottle and back again will suffer from nipple confusion. Bottle nipples flow faster than the breast, and babies often refuse the breast once they develop a dependency on the bottle.
Many parents find that infants accept supplemental feedings more easily from Dad than from Mom. A baby grows comfortable with the breastfeeding relationship she establishes with her mother and can sometimes be confused when her breastfeeding buddy tries to offer a less satisfying alternative. Supplemental and alternative feeding methods give Dad a wonderful opportunity to take part in the feeding of his child. Many fathers enjoy being able to solve problems, and giving supplemental feedings can be a rewarding way to help them feel more connected to their children.