Breastfeeding Your Adopted Baby - by Dr. Jack
>>USING A LACTATION AID -
by Dr. Jack Newman
(supplemental nursing system)
A lactation aid is a device that allows a
breastfeeding mother to supplement her baby
with expressed breastmilk, formula, glucose
water with added colostrum
or glucose water without using an artificial nipple. The early use of an artificial
nipple may result in the baby
becoming "bottle spoiled" or "nipple confused" because it interferes with the
way a baby latches on to the breast. Actually, the baby is not confused. The
baby knows exactly what the score is. If he goes to the breast and gets little
milk and slow flow and then gets a bottle with rapid flow, especially in the
first few days, most can figure that one
out fairly quickly.
The better a baby latches on, the easier it is for him to get milk, particularly
if the mother's supply is low. In the first few days, there is not a lot of milk,
but there is enough, if the baby gets what's available. But, because of a poor
latch, if the baby does not get milk well from the breast, he may fall asleep
or push away from the breast when the flow of milk slows down. Thus the baby
may refuse the breast, be very fussy at the breast, gain weight poorly, lose
weight or even become dehydrated in the first week. The mother may develop sore
nipples. Though artificial nipples do not always cause problems, their use when
things are already going badly will rarely make things better, and usually make
things worse. I do not believe that the "newer bottles
nipples" are any better than the old ones. The lactation aid is by far the best
way to supplement, if the supplement is truly necessary. (However, proper latching
on of the baby usually allows the baby to get more milk, and thus it is often
possible to avoid the supplement). It is better than using a syringe, cup feeding,
finger feeding or any other method, since the baby is at the breast and breastfeeding.
Babies, like adults, learn by doing. Furthermore, the baby supplemented at the
breast is also getting breastmilk from the breast. And there is more to breastfeeding
than breastmilk. Why is the lactation aid better?
What is a lactation aid?
- Babies learn to breastfeed by breastfeeding
- Mothers learn to breastfeed by breastfeeding
- The baby continues to get your milk even while being supplemented
- The baby will not reject the breast, which is very possible if supplementing
off the breast
- There is more to breastfeeding than the breastmilk
A lactation aid consists of a container for the supplement -- usually a feeding
bottle with an enlarged nipple hole -- and a long, thin tube leading from this
container. Manufactured lactation aids are also available and are easier to use
in some situations, but not necessarily. Manufactured lactation aids are particularly
useful when the need for a lactation aid arises in an older baby, when a mother
needs to supplement twins, when the need for a lactation aid will be long term,
or whenever difficulty arises using the improvised lactation aid. Though the
manufactured lactation aid is not inexpensive, the cost is about equal to two
weeks of the usual milk based formula.
Please Note: Using a tube with a syringe, with or without a plunger, instead
of the setup mentioned above, seems unnecessarily complicated and adds nothing
to the effectiveness of the technique. On
the contrary, it is more cumbersome.
Using the lactation aid (Improvised). (Use should be shown by a person
experienced in helping mothers with breastfeeding)
Cleaning the device
- The baby may be latched on to the breast first, and the tube slipped into
the baby's mouth at the appropriate time (after the baby has nursed on at
least both sides first). The better the latch, the better the baby will get
your milk and the easier the aid will be to use, and the more quickly you
will be able to get rid of it and the supplements. The breast should be gently
eased out of the way so that the corner of the baby's mouth is seen, and
the tube, held between the index finger and thumb, should be slipped into
the corner of the baby's mouth so that it enters straight towards the back
of the baby's mouth and at the same time, slightly upwards towards the roof
of the mouth. The tube is well placed when the supplemental fluid works its
way down the tube at a rather rapid rate. There is usually no need to fill
the tube with supplemental fluid before putting it into the baby's mouth.
- Or, the baby is latched on to the breast and the tube, which is run along
the mother's breast and nipple, at the same time. The better the baby's latch,
the easier the lactation aid is to use. Also, the better the latch, the more
likely and the more rapidly the baby will be able to do without the lactation
aid. Therefore, proper positioning and latching on of the baby are still
- The tube may be taped to the breast if the mother desires, though this
is not really necessary and not always helpful.
- The tube does not need to pass the end of the nipple and needs to be only
just past the baby's gums to function properly. It does seem to function
better if the tube is placed in the corner of the baby's mouth and enters
straight into the baby's mouth over the tongue. (Point it slightly to the
roof of the baby's mouth). It is occasionally helpful for the mother to hold
the tube in place with her finger, as some babies tend to push the tube out
of position with their tongues.
- The bottle containing the supplement should not be higher than the baby's
head. If the lactation aid functions only when the bottle is held higher
than the baby's head, something is wrong. Keep the bottle higher only if
the doctor or lactation specialist suggests this.
- Unless otherwise instructed, it is best to use the tube with every feed,
though some mothers find it easier not to use it during the night. Better
eight supplements a day of 30 ml (1 ounce) per feeding than 2 large supplements
a day of 120 ml (4 ounces) each.
- Do not cut off the end of the tube. It works fine as it is.
- It should not take an hour for the baby to drink an ounce of milk from
the lactation aid. If it is taking this long, the tube is probably not well
positioned, or the baby is poorly latched on, or both. When the lactation
aid is functioning well, it takes 15-20 minutes, usually less, for the baby
to take 30 ml of the supplement.
- A trick for easier use: Wear a shirt with pockets, and put the bottle in
Weaning the baby from the lactation device
- Do not boil the tube of the non-manufactured aid. It is not made to be
- After using the device, clean the bottle and nipple as usual. Do not boil
the tube. The tube should be emptied after use and then rinsed through with
hot water (suck up hot water into the tube from a cup) and then hung up to
dry. Soap, though not necessary, may be used if desired, but rinse the tube
well. Tubes may become stiff and unsuitable for use after about a week.
Questions? Get Dr. Jack Newman's book The
Ultimate Breastfeeding Book of Answers.
- Maintain contact with the breastfeeding clinic for advice about weaning
the baby from the lactation aid. See the Protocol to Increase Breastmilk
Intake by the Baby.
- Weaning the baby from the aid may take several weeks or only a short while.
Do not be discouraged and do not try to force the weaning. Usually, the amount
of milk required in the lactation aid increases over one or two weeks, and
then levels out for a variable period of time before decreasing. The whole
process may take two to eight weeks, although some mothers have used the
device only a few days, whereas others have not been able to stop it at all.
Rapid improvement sometimes occurs after a long period of little change.
- Observe the baby's nursing. If you do not know how to know
if the baby is drinking, ask. Put the baby onto the breast, allow the baby
to nurse as
long as he is suckling and drinking, then use breast compression (handout
#15, Breast Compression)
to keep the baby drinking; then repeat the process on the second breast.
You can return to the first breast and continue back and forth as long as
the baby is drinking. After you have finished feeding on both breasts, insert
the tube into the baby's mouth. Allow the baby to nurse until satisfied using
the lactation aid.