Hi, When I supplement at the breast it's usu. because I'm observing a baby that fights the breast which I generally see after 24 hrs. or the baby latches and then just sits there. I use a 5Fr feeding tube and 10 cc syringe. If baby responds to the increased volume by demonstrating better hunger cues, suck swallow pattern and overall relaxing with the feeding, then I proceed to the Starter SNS. I don't send the parents home with the feeding tube and syringe because it is something I put together and don't want to worry about liability. If they're very motivated, I might start with the SNS.
Christine  Raasch, RN, BSN, IBCLC

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