Denise wrote:

>What is a good explanation for how the supplementation technique of =
>feeding tube devices work,with regards to how baby "knows how to take =
>less supplement from tubing and more from the breast"?Is this physics or =
>is it that baby sucks less from the tube itself when he is satiated more =
>from mom's milk flow.

Denise, I've always thought that the increased suckling at the breast induced
by use of the SNS increased mom's supply over time, so that eventually baby
gets more breast milk with every suckle, gets full more quickly, and more
formula is left in the SNS at the end of feedings.   I haven't seen a really
strong demonstration of this until recently.  I'm working with a mom whose
baby is about 6 weeks old.  Baby seemed to be nursing well when she left the
hospital, but weight gain was lousy--baby was seriously underweight at 2 week
exam.  Mom came to me for help--we looked at suck, which was pretty weak, but
I didn't know if it was cause or effect.  In any event, mom supplemented with
dropper feeding for one week, baby gained something like 14 ounces.  Then we
went to the SNS--baby's gain continued to be nearly a pound per week.  Over
the past three weeks, baby has decreased formula intake from an average of
about 17 ounces/day to 12 ounces/day, although mom had stopped use of the SNS
for night feeds five days before the last weight check. The test weights
showed just a few cc's intake fhe first week, gradually increasing to 64 cc's
at the last test weight.  I'm thrilled, the mom, who is truly a saint, is
thrilled,  I suppose the pediatrician is thrilled (or at least satisfied--his
usual advice is to start formula at the two week exam if the baby is even
slightly low), and the baby's nickname is now "Porkchop."  We're trying the
SNS only three times a day this week, will see what happens.  I really
thought this mom just didn't have enough glandular tissue--she's 36, first
baby--but it looks as if the poor supply was a result of poor suck.  Mom
reported a definite increase in strength of suck as baby gained weight. I'm
hopeful, for the first time this week, that mom will soon be able to
eliminate the SNS entirely.

Judy D in WV