Dear Carol,
       In my opinion, you need to find another way to supplement.  I have
*never* seen a baby 4 mos old or older (and some as young as 3 mos.) accept a
tube on a breast that never had one before.  Babies are very smart, and they know
what the breast is supposed to look like during feedings.  4-mo-olds will
either get angry at the tube and try to rip it off, or they will think it's a new
toy and play with it, but either way they aren't nursing.
       Likewise, some adoptive moms want to nurse sometimes without the
SNS/Lact-Aid at 6-7 mos., once solids have replaced some of the formula supplement.
 But I have seen babies who have *always* nursed with a tube on the breast,
refuse to latch when the tube is missing.  So when I get calls from moms who
want to find out more about breastfeeding an adopted baby, I always suggest
that, if they plan to use a feeding tube for supplement, they use the feeding tube
when the baby is truly hungry, and offer the breast without the feeding tube
when baby just needs to suck for other reasons (like didn't manage to fall
asleep while feeding).  That way, the baby gets used to being at breast both with
and without tubing from the beginning, and it's not a big deal to nurse
without the tubing at 6 mos. then.
       Has the mom ruled out possible pregnancy as a cause of sudden low
supply?  If she's not pregnant, then perhaps she could pump to rebuild supply, and
offer the baby what she's pumped in a cup, until the supply is better and
baby can then take it right from breast with the rest of his feeding.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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