I know that this seems like an elementary question and for those that work with SNS's daily I'm sure it is that is why I seek your collective wisdom. I thankfully don't often have the occasion to recommend it's use often and when I do I find I stumble over the logistics of it's use. I had a mom that wanted to get baby "back to breast" after one week of using ABM and not being able to latch baby after grandma suggested she use a bottle because the baby "wasn't getting anything". Mom was very upset and felt grandma (her mom) had sabotaged her efforts. I suggested the use of an SNS/electric pump as we were able to get baby to the breast and latched without alot of distress on the baby's part. Here is the logistics question: If she pumps prior to a feed then the baby will most likely use whatever she pumps, then there will be no leftovers and no way for her to tell how much to reduce the amount in the SNS by next time. If she pumps after the feed, she will probably not get much to put in the SNS the next time and will have to resort to using ABM as the supplement. As I am writing this (its amazing how much clearer things seem when your not in the midst of chaos) I'm thinking probably best to recommend pumping in between nursing sessions like an hour after/before nursing but it seems like a lot to ask and there really is no way to predict when the baby will want to nurse again anyway. Can someone help me over this stumbling block? I can't believe I'm having this much difficulty with what seems like such a simple question. Ilene Fabisch, IBCLC, LLLL, WIC Bf Co and NE Rep Brockton, MA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html