I would appreciate some tips on using the SNS. I have had several mothers
use it successfully with babies who were latching well but had low milk
supply. I posted last week about a mom with a 2 week old  10 lb baby who had
not latched since birth. Baby had tongue tie and mom was only pumping with
single pump twice in 24 hours. Baby was fed EBM and formula by bottle.Mother
was getting about 10-16 oz per day of EBM. We increased pumping using double
pump setup.Never did get up to my recommendations re. frequency but did
manage at least 4 pumpings in 24 hours.Mom has cystic fibrosis. Baby is now
3 weeks old. managed to have frenotomy done yesterday. Big difference in
tongue movement, now reaches lower lip, before did not cover lower gums.My
main concern now is that in past week mothers supply has dwindled
drastically to about 4 oz in 24 hours. She has been passing clots and heavy
bleeding. Family physician has started on antibiotics for
infection.Physician has agreed to try domperidone to increase milk supply. I
have emphasised need for frequent pumping. Mother committed to breastfeed
and has very supportive partner. Baby has made progress in latching on. I
have seen mom every day for short attempts at latching. yesterday baby
latched beautifully in football hold but would only do non nutritive suck.
Some nutritive sucking with sns in place.I feel this baby would suck well
with nice full breast. Mom has tried sns but finds it very awkward trying to
achieve good latch and ensure correct placement of tubing. I feel we have
made great progress in getting this baby to take breast, but now need sns to
work well.
Do any of you have some good tips for working with sns? mother also has
arthritis in hands and finds it difficult supporting large baby.What about
tips for placement of tape? We have tried syringe and #5 feeding tube but
mom doesn't think she could manage on her own. Please Email me privately as
i am sure this has been discussed extensively.
Janet Murphy Goodridge, RN,MN,IBCLC
St.John's, NF