Dear Lactnetters,
    Using a tube supplementer or SNS at breast can be a great way for moms to supplement, as we all know.  As previous posts  have mentioned, the factors that make it work include mom's willingness to use it, baby's latch ability and nipple anatomy.  I have seen countless mothers struggle with its use if they are already having over-whelming latch issues.
    Often I will try a Starter SNS and if the baby and mom find using that is "do-able" then we will go to the SNS unit.  Sometimes taping up one tube (wrapping it in circles) to the bottle portion helps if baby is knocking off/entangling the 2nd tubing and it is less cumbersome to mom.  It can also be vented from the 2nd tube without leaking for a faster flow this way.  Venting can also be done throughout the feeding to keep baby from deferring to SNS tube flow.
    When gauging intake with scales I often see baby taking less from the breast and more from the SNS than when we have done previous intakes without it.  It has made me wonder if they really stimulate the extra let-downs and drain the breast as effectively.  Having said that, it still is the best  vehicle for mothers to supplement without having to stop at breast and then use a bottle and saves 2 hours plus a day of bottle feeding.  Moms either love or hate it.
    The Journal for Human Lactation had a mother based article a few years ago.  The link to the abstract is:  http://jhl.sagepub.com/cgi/content/abstract/21/4/429 
 
Jan Ellen Brown RDH IBCLC
The Nursing Mother's Place
Presbyterian Hospital, Charlotte, NC USA

 
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