So, all of you:

I had a thought on a quick and dirty study to respond to Karleen's question
on stimulating supply. Its not ideal, but it might work as a starting point.

Any of you that do use supplementing devices at the breast (SNS, syringe
and tube, Lactaid) could participate.

Study design:  cross-sectional, observation

Recruitment:  Initial visit, babies who are not gaining adequately or lost
excessive weight (we could choose tighter or looser parameters) or have
been , mothers who are willing to use a tube at the breast

Information to collect:
1) Device type
2) Tube placement
3) Diameter of tubing
4) Venting - yes/no
5) Age of baby
6) GA of baby at birth
7) Supplement consumed from device
8) Amount consumed from breast(measured via weighing scale with accuracy of
0.1-0.2 oz)
10) Ratio of formula to breast milk consumed in last 24 hours, if they were
supplementing on recruitment
9) Ratio of formula to breast milk consumed in the 24 hours post visit.
10) Qualitative description of suck - perhaps Cathy Genna or someone like
her with a strong interest in suck issues could come up with a SIMPLE
qualitative tool - since you couldn't standardize without bringing all the
LCs together to validate our observation

With a large sample size - we could go through a lot of characteristics to
determine what factors make a difference for better milk transfer with
supplemental devices on the breast.

Of course I'd love to do a prospective study, but it takes a lot more time
to design such a study.  This could be a precursor for a follow up
propspective study.

Anyone intersted?

Susan Burger, MHS, PhD, IBCLC

All this from someone who has developed an intense dislike of the SNS, but
realizes it is helpful sometimes.

PS.  The first qualitative piece - would be to do a quick study of LCs to
find out what factors YOU think are important to investigate in terms of
making a difference for milk transfer with these devices.

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