I have a mom who has given me permission to ask this question. She is using a full SNS for two weeks now, baby is almost 8 weeks old. Baby has never breastfed well, and I began to help her when baby was almost 6 weeks old. Baby was still at birth weight at one month of age. Lots of supplementing the first two weeks, none the second two weeks. Recessed chin, slight tongue-tie, tongue thrusting at that time. Hospital given nipple shield which baby was tip sucking on and bobbing back and forth on. Mom could pump 1/2 to 1 oz total on a new Pump In Style (not advanced) before we began the SNS. Total formula at that time was 24 oz a day using the SNS.

I have done 3 visits, and each time baby took about 1 oz from mom's breasts and 3-4 oz. in supplement from an SNS. Baby prefers the large tubing. Baby continues to take 20 oz in 24 hours. I believe baby takes about 30 oz total per day. Last week, baby gained 1 pound in 9 days. Baby latches well now, and no longer tongue thrusts. Sometimes will nurse without SNS after finishing all the formula that was in it to begin with. Baby now at normal weight for age. Mom feels fuller and can squeeze out drops of milk which she couldn't before we started. Has had several periods of feeling engorged in the last week.

Mom wants to know if anyone can tell her how long she should keep up this regiment until she has total bf success (no SNS). She is feeling frustrated at how much formula he is still taking in. She nursed yesterday 12 times with SNS and used 20 oz. formula the entire time. The day before she used 18 oz. She used her PNS twice yesterday. Never more than 1 oz total from PNS use. I have suggested galactagogues, rental pump, and also gave information on the tongue tie issue. She is willing to try fenugreek and blessed thistle today. 

Thanks, Kathy Eng, BSW, IBCLC
Houston, TX, USA

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