Like JP, I have used supplementers, both the Lact-Aid and SNS (and by far preferred the Lact-Aid), over the long term, and also been in contact with many other moms who have, mostly with adopted babies, but also a few who had given birth and had some kind of issue that made supplementation at the breast the best way to keep the baby breastfeeding.

I think bio moms tend to have a harder time accepting the need to do this and/or the benefits of breastfeeding this way, over going to a bottle.  In recent years, we have seen the same thing in adoptive moms who have done the extensive  BCP/domperidone treatment, with the expectation of being able to breastfeed without the need of supplementation.  It is sad when a baby (and mom) misses out on the benefits of being nurtured at the breast, because the mother is seeing that, and providing some amount of milk for him, but not enough to feed him completely, as not successful.  

There is no reason that long term supplementation at the breast can't work just as well for a bio mom as for an adoptive mom.  The benefits of nurturing at the breast need, and deserve, to be stressed.  In these days of such common use of breast pumps, I think the nurturing benefits kind of get lost sometimes.  Also, the benefit of any amount of breast milk needs to be stressed, especially if there is a supply issue and the mother is not able to pump enough milk to use in the supplementer.  

I have nursed a child with a supplementer for as long as two years, and have known others who have done so for up to three years.  Whether or not the transition can be made to the breast alone depends on lots of factors.  The amount of milk the baby can get directly from the breast is only one of them.  Some kids are flexible and some just want their feeding/nurturing time to be a certain way and are not interested in changes.  I think that, actually, many more kids would eventually take the breast without it, if mother persists, but many mothers who have been using it for an extended period all ready will choose to just keep using it, rather than stress over trying to get the baby to nurse without it.  Also, there are a few older babies who will lose interest in the breast, without it.

In my case, of the four adopted children that I nursed until they self-weaned, two made the transition to nursing without the supplementer, and two did not.   However, with the first of these, Thomas, I regretted giving up the Lact-Aid.  After 18 months of using it, I had decided to go a day without offering it and see what he would do.  He went almost a day without nursing, but then climbed up on my lap and nursed himself to sleep.  He did not wean completely until he was four and a half.  However, he did not suck nearly as well, or for as long, without the Lact-Aid and, during the period between him starting to nurse without the Lact-Aid, and me finally getting Julia nursing, I don't think he was getting more than drops of milk.  Because of that, I decided not to try very hard to get the next two to nurse without it.   Joanna, my last one, just moved the Lact-Aid tube away one day when she was about a year old, and nursed fine without it.  That was after I had gotten a depo provera shot, which definitely increase my milk production.

For a mother who is currently using the SNS, I would suggest using the smallest tubing, if possible.  I would also suggest that she consider trying the Lact-Aid.  It offers many benefits over the SNS, especially for someone who anticipates needing to use it for a long period.   One of the benefits, which would be especially helpful for a bio mom, is that the Lact-Aid can be used in front of others without anyone seeing it.  This is important for adoptive moms, too, but it doesn't surprise anyone to know that we would need to supplement.  The Lact-Aid is also much easier to get set up to nurse with, more comfortable to wear, and some babies suck much better with it than with the SNS, even with the smallest tubing.  

I wish the mom about whom this thread was started the best, at providing her baby with benefits that cannot be duplicated!

Darillyn Starr

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