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    Using an SNS

    There are different types of supplemental nursing systems. Each works a little differently and can be used in a variety of circumstances. They provide a great alternative to bottles or other feeding devices if you want to feed your baby directly at your chest. There are many benefits for both parent and baby, but some challenges with each system as well. Many situations can arise when a supplemental nursing system is a helpful short term or long term tool during your breastfeeding journey. 


    When you might use a supplemental nursing system:

    • Premature birth - When a baby is born prematurely, they may not have the strength or muscle coordination to sustain latching deeply at breast and efficiently nurse. They may tire very quickly at the breast. Using a supplementer at the parent/s chest gives the baby the nutrition and calories they need while offering a little support so they do not have to work as hard or tire as quickly. Allowing the baby to be fed directly at the breast helps develop the muscles needed for breastfeeding, allows parent and baby to be skin to skin and deepen their bond.
    • Induced lactation - People who are adopting their baby can have a breastfeeding relationship, too. Inducing lactation is a process that starts usually a couple months before the baby arrives, but continues after the baby arrives. Using a supplemental nursing system once the baby arrives can allow the non-gestational parent to begin feeding at breast/chest and can help increase milk supply from the baby’s sucking at breast/chest.(1) Not all people who induce lactation are able to establish a full milk supply. The use of a supplemental system at the chest does not interfere with being able to still have a chest/breastfeeding relationship with the baby.
    • Re-lactation - There are many instances a parent stops nursing and then decides they would like to initiate breastfeeding again. Using the supplemental nursing system helps provide the baby milk they need in the supplementer and because the feeding is at breast, they are also stimulating the parents' milk supply. Additional pumping may be necessary as decided by you and your IBCLC, but stimulation by the baby is often more effective than a pump alone for increasing milk supply.
    • Co-nursing - A supplemental nursing system allows the non-birthing parent to induce lactation or use expressed milk or formula to have a chestfeeding relationship with their baby and share the in feeding responsibility.(1)
    • Latching difficulties - Supplemental nursing systems can be helpful if your baby is able to latch, but is not able to effectively get enough milk out themselves. Short term use of a supplemental nursing system at breast allows you time to get to the root of the issues causing difficulties and still have your baby being fed at breast. They receive your milk through the supplementer and are able to work on their skills for feeding at breast simultaneously.  Babies who have oral restrictions or other oral function challenges tend to do better at breast when there is good milk flow. They may not be able to create that flow themselves and the supplemental nursing system can offer the flow they need which encourages them to suck and become stronger at feeding. As they become more efficient at feeding, the supplementer can be relied on less and less.
    • Low milk supply - Chronic low milk supply can happen for different reasons, but it doesn't mean you can’t have a breastfeeding relationship with your child. Breastfeeding is a way to offer comfort to your baby and enhance the parent child bond. Breastfeeding plays a significant role in oral development. Breast tissue fills the oral cavity and presses up against the palate, widening the palate and drawing it away from the nasal cavity. The jaw movements during breastfeeding encourage the lower jaw to grow forward as intended. During breastfeeding, the tongue moves in a wave-like motion different from bottle feeding where the tongue's action is a thrusting forward and back motion.(2) This can later interfere with proper swallowing. Using a supplementer at breast affords your baby all the amazing benefits of breastfeeding even if you are using donor milk or formula to add to your own milk supply.

    Types of supplemental nursing systems:

    • Medela Supplemental Nursing System has a firm, BPA plastic container for holding milk. Two tubes connect to the bottle which are placed on the parent’s chest near the nipple. This system uses gravity. The bottle can also be squeezed gently to encourage the milk to flow through the tube. It is less expensive than the Lact-aid system and more cost effective for short term use. One advantage of it is the bottle is washed and reused each time. It can be bulky, cumbersome and not very discreet to use. It is helpful when the baby does not have as strong of a suck. 
    • Lact-aid was developed by a husband and wife team who wanted to be able to breastfeed their adopted children. This system is often preferred for long term use over the Medela SNS. The holding vessel is a BPA free bag that is flexible. A short tube is inserted in the bag and attached with a specially designed connector ring with the feeding tube coming out the top end. It is a more expensive system, but is easier to use and is very discreet to wear. It does require ongoing purchase for new bags. The system requires the baby to suck to get milk out as it is not gravity driven.
    • Syringe supplementer is a nice option for a few days when feeding small amounts of colostrum. They are less convenient when the baby needs a larger volume of milk since the syringe doesn’t hold larger amounts. A syringe allows the parent to press the plunger and control the flow or use the system as a finger feeder.
    • Homemade systems can be made from snipping the hole in the top of a bottle a little wider and inserting a thin feeding tube into the bottle and the other end on your breast. When the bottle is placed above chest height, the milk will flow more from gravity, but it still requires the baby to suck to get milk.

    Benefits of using a supplemental nursing system:

    • It stimulates the parent’s milk supply
    • Being able to bond with your baby
    • Allows for more skin to skin contact
    • Allows the baby and parent to learn to breastfeed by breast/chestfeeding
    • Your baby gets milk from you in even while supplementing
    • The parent gets the full experience of breastfeeding
    • The baby learns they are comforted at the chest/breast
    • The baby gets the benefits of muscle and oral development from breastfeeding

    Challenges of using a supplemental nursing system:

    • Takes practice and time to learn
    • Can leak sometimes
    • Doesn’t work for all babies
    • Tubing can be tricky to clean

    All supplemental nursing systems have a learning curve to use, but they offer a lot of benefits for being able to sustain a breastfeeding relationship. Many people find a supplemental nursing system to be well worth the investment of time and practice to be able to experience all the joys of nursing their baby. Working with an IBCLC and experimenting yourself will help you become comfortable using a system that works well for you and your baby whether you are using it for a short period of time or for the entirety of your nursing journey.




    Footnotes:

    1. https://www.llli.org/breastfeeding-without-giving-birth-2/
    2. https://www.brianpalmerdds.com/bfing_import.htm


    Resources:

    https://www.brianpalmerdds.com/bfeed_frenulums.htm


    https://happyhumanpacifier.com/which-supplemental-nursing-system


    https://www.lact-aid.com/additional-trainers/


    https://adoption.com/which-nursing-supplementer-should-i-use


    https://www.canadianbreastfeedingfoundation.org/basics/lactation_aid.shtml


    https://ibconline.ca/information-sheets/lactation-aid/


    https://breastfeeding.support/supplementing-at-the-breast/





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