The
better a baby latches on, the easier it is for him to get
milk. If the baby does not get milk well from the breast,
he may fall asleep or push away from the breast when the flow
of milk slows down. Thus the baby may refuse the breast, be
very fussy at the breast, gain weight poorly, lose weight
or even become dehydrated. The mother may develop sore nipples.
Though artificial nipples do not always cause problems, their
use when things are already going badly will rarely make things
better, and usually make things worse. The lactation aid is
by far the best way to supplement, if the supplement is truly
necessary. (However, proper latching on of the baby usually
allows the baby to get more milk, and thus it is often possible
to avoid the supplement). It is better than using a syringe,
cup feeding, finger feeding or any other method, since the
baby is at the breast and breastfeeding. Babies, like adults,
learn by doing. Furthermore, the baby supplemented at the
breast is also getting breastmilk from the breast.
A
lactation aid consists of a container for the supplement-usually
a feeding bottle with an enlarged nipple hole-and a long,
thin tube leading from this container. Manufactured lactation
aids are available and are easier to use in some situations,
but not necessarily so. Manufactured lactation aids are particularly
useful when the need for a lactation aid arises in an older
baby, when a mother needs to supplement twins, when the need
for a lactation aid will be long term, or whenever difficulty
arises using the improvised lactation aid. Though the manufactured
lactation aid is not inexpensive, the cost is about equal
to 2 weeks of the usual milk based formula.
Please
Note: Using a tube with a syringe, with or without a plunger,
instead of the setup mentioned above, seems unnecessarily
complicated and adds nothing to the effectiveness of the technique.
On the contrary, it is more cumbersome.
Using
the Lactation Aid (Improvised)
- The
baby may be latched on to the breast first, and the tube
slipped into the baby's mouth at the appropriate time.
The better the latch, the better the baby will get your
milk and the easier the aid will be to use, and the more
quickly you will be able to get rid of the supplements.
The breast should be gently eased out of the way so that
the corner of the baby's mouth is seen, and the tube,
held between the index finger and thumb, should be slipped
into the corner of the baby's mouth so that it enters
straight towards the back of the baby's mouth and at the
same time, upwards towards the roof of the mouth. The
tube is well placed when the supplemental fluid works
its way down the tube at a rather rapid rate. There is
usually no need to fill the tube with supplemental fluid
before putting it into the baby's mouth.
- Or,
the baby is latched on to the breast and the tube, which
is run along the mother's breast and nipple, at the same
time. The better the baby's latch, the easier the lactation
aid is to use. Also, the better the latch, the more likely
and the more rapidly the baby will be able to do without
the lactation aid. Therefore, proper positioning and latching
on of the baby are still very important.
- The
tube may be taped to the breast if the mother desires,
though this is not really necessary and not always helpful.
- The
tube does not need to pass the end of the nipple and needs
to be only just past the baby's gums to function properly.
It does seem to function better if the tube is placed
in the corner of the baby's mouth and enters straight
into the baby's mouth over the tongue. (Point it to the
roof of the baby's mouth). It is occasionally helpful
for the mother to hold the tube in place with her finger,
as some babies tend to push the tube out of position with
their tongues.
- The
bottle containing the supplement should not ordinarily
be higher than the baby's head. If the lactation aid functions
only when the bottle is held higher than the baby's head,
something is wrong. Keep the bottle higher only if this
is suggested by the doctor or lactation specialist.
- Unless
otherwise instructed, it is best to use the tube with
every feed, though some mothers find it easier not to
use it during the night.
- Do
not cut off the end of the tube. It works fine as it is.
- It
should not take an hour for the baby to drink an ounce
of milk from the lactation aid. If it is taking this long,
the tube is probably not well positioned, or the baby
is poorly latched on, or both. When the lactation aid
is functioning well, it takes 15-20 minutes, usually less,
for the baby to take an ounce of the supplement.
Cleaning
the Device
- Do
not boil the tube of the non-manufactured aid. It is not
made to be boiled.
- After
using the device, clean the bottle and nipple as usual.
Do not boil the tube. The tube should be emptied after
use and then rinsed through with hot water (suck up hot
water into the tube from a cup) and then hung up to dry.
Soap, though not necessary, may be used if desired, but
rinse the tube well. Tubes may become stiff and unsuitable
for use after about a week.
Weaning
the Baby from the Lactation Device
- Maintain
contact with the breastfeeding clinic for advice about
weaning the baby from the lactation aid.
- Weaning
the baby from the aid may take several weeks or only a
short while. Do not be discouraged and do not try to force
the weaning. Usually, the amount of milk required in the
lactation aid increases over 1-2 weeks, then levels out
for a variable period of time before decreasing. The whole
process may take 2-8 weeks, although some mothers have
used the device only a few days, whereas others have not
been able to stop it at all. Rapid improvement sometimes
occurs after a long period of little change.
- Observe
the baby's nursing. If you do not know how to
know if the baby is drinking, ask. Put the baby
onto the breast, allow the baby to nurse as long
as he is suckling and drinking, then use breast
compression (handout #15 Breast
Compression) to keep the baby drinking;
then repeat the process on the second breast.
You can return to the first breast and continue
back and forth as long as the baby is drinking.
After you have finished feeding on both breasts,
insert the tube into the baby's mouth. Allow the
baby to nurse until satisfied using the lactation
aid.
- The
bottle of the lactation aid can be lowered 6-12 inches
below the baby's head, but do this only if the baby is
drinking very quickly.
Handout
#5. Lactation Aid. Revised January 1998
Jack
Newman, MD, FRCPC is a pediatrician, a graduate of the University
of Toronto medical school. He started the first hospital-based
breastfeeding clinic in Canada in 1984. He has been a consultant
with UNICEF for the Baby Friendly Hospital Initiative in Africa.
Dr. Newman has practiced as a physician in Canada, New Zealand,
and South Africa.
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