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Subject:
From:
Ann Perry <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 24 Jun 2000 10:12:33 EDT
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My understanding of how the SNS is best used is to have it attached from the
beginning of the feeding and open.
Depending on the reason the SNS is being used will determine how long a
mother may need to use it but the way it is used stays the same.
I have used them for adopted babies and to increase milk supply.  The level
of the tube where it comes out of the bottle needs to be at the baby's chin
so there is required sucking to obtain milk, so not to be placed above the
chin. If placed too far below the baby may be frustrated with the lack of
anything coming out and not stay on the breast.  Usually these babies who are
requiring this intervention will not stay on the breast if there is little or
no milk coming.  The SNS rewards their efforts and keeps them sucking at the
breast, this in turn stimulates mom's hormones for MER and increase
production.  The physics behind the SNS is that if the volume from the breast
is greater than the SNS then the milk does not empty from the system.  Now, I
am not a physicist, but I have seen this work.
If a baby has lost a large amount of weight or the mom has been supplementing
in increasing amounts I will suggest the SNS as long as the baby will latch.
I give them a well defined time line so they do not reject this intervention.
 I usually say 2 weeks, evaluating after one week.  During this time I am
trying to increase the strength of the baby's sucking by changing the tubing
to a narrower one.  Also I try to find out from the mom's if any of the
feedings their breast are fuller and those are the feedings where I start the
weaning of the SNS.  Moms can be overwhelmed by this intervention and that is
why I do not state they may have to use it an indefinite period.  I'd rather
give it a shot and then see how things are progressing and then make other
plans after that.
Sorry this is so long.
Rob, I hope this helps.
Ann Perry RN IBCLC
Boston, Mass

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