I suspect that when you say "lactaid" you are using it as a generic term and not referring to the original at-breast supplementer, the Lact-Aid?  Are you referring to the homemade one, of a feeding tube inserted into an enlarged bottle nipple?  I can't tell you anything about what day to use it, or anything like that, but I do have a lot of experience with using such a device, and assisting others, mostly adoptive mothers, but some moms who have given birth and had trouble getting feeding at the breast established.  

Like everything, it can be overused.  However, I think it is often better than any other alternative, because it keeps the baby at the breast.  The home-made thing I described is not something that would be that simple for a mother to use, by herself, at home, but the Lact-Aid can be used, with a little practice, for months, if necessary.  It can be used both for inadequate supply and inadequate suck.  In the latter case, the Lact-Aid can be worn inverted, so that gravity will assist the flow, if the baby's such is inadequate to express the breast and the device.  The SNS will flow by gravity as long as the tube that is not in the baby's mouth is left open.  

Babies can get hooked on it, where they won't take the breast without it.  That is usually with a baby who is beyond the newborn period, though.  I have used it for as long as 25 months, with a baby who wouldn't suck right unless it was there but, since my induced supply was always on the small side, it wasn't worth fighting too hard to remove it.  In a case where mom's supply is adequate, and baby is still 4-6 months or under there are tricks to getting around that.  For example, if the Lact-Aid is filled with all air removed, when it is empty, the baby will not suck air, but still have the feel of the tube there.  Or, the tube can be clipped shut with a hair clip.  The SNS has a slit that the tube can be put into to cut off the flow, while still leaving the tube on the breast.  If the Lact-Aid is being used without taping, which is usually the case, except for the first few feedings with it, the tube can just be pulled out of the baby's mouth.  With most of my kids, if I started the feeding with a couple ounces in the Lact-Aid, I could often pull the tube out after a while, and they would keep sucking.  

I would be happy to try to share some ideas on specific situations, if you or anyone else is interested. I realize that most of the moms those of you here work with would not need to use a tube device for very long, but there are a few who would need to.  Not many mothers who have given birth are willing to use a supplementer, at least not for very long, but they can do it as well as adoptive moms can, if they have the incentive.  I think the reason is that adoptive moms expect breastfeeding to be a big challenge, so we are more prepared to put more into it, and have more modest expectations when it comes to milk supply.  Whatever the reason, though, it can be just as rewarding for bio moms, if they can focus on the benefits of the relationship, which is the same regardless of the need for supplementation.

I remember one case I worked with, that I was very gratified to be able to help with.  Mom had all ready nursed three babies successfully and never had any problems with milk supply.  Then, along came baby number four, who had a weak suck.  The LC I was working with evaluated the baby's oral anatomy and suck and lots of things were tried, but baby's suck remained weak.  Mom was very motivated to keep her at the breast, so we set her up with the Lact-Aid.  She used it for every feeding, then pumped, and used what she got in the Lact-Aid for the next feeding. She kept doing this until her daughter was on solids and other liquids by cup.  

Another situation that I faced, with one of my sons, and have known about bio moms who faced, is where baby is born with an especially tiny mouth and tongue. The Lact-Aid can be used to keep the baby feeding at the breast until he/she has grown enough to make a deeper latch possible.  After his mouth had grown, my son eventually became one of my best nursers and was the one of my six adopted children who got the most milk from me.  Last year, he had a son who was also born with a very tiny mouth and tongue.  The mother only tried nursing a few times, and then started a four month struggle to find a formula that didn't make him miserable.  My advice in the interest of my grandson was not welcome; a frustration I am sure many here have faced!

 		 	   		  
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