I find it highly unlikely that the SNS would flow in such a way that the
breast is drained preferentially.

I teach the mothers:

1. How to know the baby is getting milk (open--*pause*--close type of suck).

2. When the baby no longer *drinks* (not just sucks), use compression.

3. When compression no longer works, offer the other side, and repeat.

4. Do at least both sides until the baby does not drink and then introduce
the tube or open the SNS and let the baby drink as much as he wants.

In that way, as the mother gets more milk (or, perhaps more correctly), or
the baby gets more milk, the mother will be supplementing later and later in
the feeding.  No need to say, supplement 1 ounces/feed now because he did
well with 2 ounces/feed. Enough numbers!!

Check with a physicist, Rob, but I would guess Yael is undoubtedly right.

Jack Newman, MD, FRCPC

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