When saying only one method is okay or not okay,  we set the client up 
for failure. I don't think any of the supplementation methods are truly 
research based, are they? Do we have any research that says an SNS works 
better than finger feeding, or that finger feeding works best over 
bottles or cup?

And I concur with Cathy, when a baby is not gaining weight properly, we 
must feed baby more than it is getting at the breast. If a baby has oral 
motor problems, it will continue to fail and not gain weight and get 
weaker if it can not remove milk properly.

We need to remember that feedings should not be a struggle for mom or 
baby. And things need to be fixed in a way that mom choses and the baby 
can manage. Babies with oral motor problems often have a fatigue point 
and after this they are not effective at removing milk at the breast. 
Sometimes they can not even bottle feed past a certain point and I have 
seen the SNS not work either. Sometimes we just have to figure out how 
to feed the baby in a way that meets mom's and baby's needs.

Kathy Eng, BSW, IBCLC

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