Oh, Wise Ones, I have a question regarding the Medela
SNS.

Several weeks ago, in my work as a hospital-based LC,
I met with a new mama who had NO palpable breast
tissue. On exam, all I felt was chest muscle and
underlying ribs.  No colostrum expressible at 48 hours
post-partum, either via pump, or manual expression.
Mother reported no breast changes in pregnancy, father
was at bedside and agreed with her observation. This
mother had almost no areolae, the border extended past
the base of the nipples only by about 0.5 cm.  In an
ironic twist, so common in lactation, Mother's nipples
were nice and grasp-able...sigh.  She had been
bringing baby to breast to suckle, then topping off
with bottle feeds of AIM.  I encouraged this and gave
her some written info on signs of adequate infant
intake (void/stool patterns, wt gain parameters,
etc.).

I then brought up the idea of using an SNS at breast,
to provide them with a feeding option.  Both parents
expressed interest; I showed them the device in the
package and they got more interested.  We busted the
thing open, and discussed and practiced its assembly
and use, and they said they would like to take it home
and see if it worked for them.  Yay!

One of my co-workers pointed out the next day that she
HATES the SNS because the container does not vent, and
as the feeding progresses, the baby has to exert more
and more force to get the fluid out through the tube,
and sometimes the holding chamber collapses!  Call me
ignorant, but this was news to me; I had not heard of
this problem before (yes, I have read the package
insert) and was horrified that I might have given this
couple incorrect information (bad advice---EEEEK!).

Anyone else have this problem with the SNS?  If so,
how do you correct it?  Heeeeellllllpppp!

Carole Jernigan, LC

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