I have a handout of guidelines for the nurses on our unit. It suggests which
alternative would be best in which situation.

In a nutshell:

SNS at the breast is recommended for :
     Baby with a good suck but needs a little extra (ie. Hyperbili, wt. loss
>10%)
     Baby is reluctant to latch but does well once latched.
     Mom has a depressed supply rlated to previous surgery etc.

SNS finger feeding is reccomended for:
     Baby needs suck training (ie. toungue to roof of mouth.)
     Baby is being fed by dad because mom is seriously ill.
     Should be avoided if mom has tight, flat of inverted nipples.

Cup Feeding is reccomended if:
     Baby has an oral eversion (ie. deep suction for meconium.)
     Mom has 'unfriendly" nipples and needs to supplement while pumping and
wearing shells to pull them out.

Haberman feeding is reccomended for:
     Prolonged supplementation for preemies, requiring feeds while mom is not
here.
     Situations where infants require suck coordination and are under the care
of an OT/PT.
     Clefts, other palate malformations.


Of course any baby can get hooked on any method but...if we think a little
before starting an alternative method, I believe we can minimize the risk. It is
good to have options...and to know how to use them.

Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati

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