Tube Feeding Devices

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There are a variety of tube feeding systems that allow mothers to supplement their babies while nursing at the breast.

Who Should Use an At-Breast Tube Feeding Device?

Tubing can be run to both breasts for tandem nursing or twin nursing. Photo courtesy of http://www.joyfulabode.com

Tubing can be run to both breasts for tandem nursing or twin nursing.
Photo courtesy of JoyfulAbode.com

These devices work well for babies who are able to latch effectively to the breast.  They are an excellent choice when a mother is attempting to increase her milk supply while breastfeeding her baby. They are also valuable when a mother must supplement but wants her baby to have the benefits of nursing – cuddling, bonding, skin-to-skin contact, proper oro-facial development, etc. Examples of situations where mothers have successfully used at-breast tube feeding systems include relactation, induced lactation, adoptive breastfeeding, nursing after breast surgery, in place of pumping to help increase low milk supply, when a baby is breastfeeding but must also have a supplement such as with PKU, in place of giving a supplement in a bottle, and more.

How Does a Tube Feeding Device Work?

This type of supplementation system consists of a container to hold the supplement (whether expressed milk, donor milk, or formula) and then thin tubing protruding from the container to the mother’s nipple. The tube is held in place by a nursing bra, nipple shield, band-aid, or hypoallergenic tape. Many moms prefer a band-aid as they can slip the tubing on and off and just leave the band-aid on their skin.  Care should be taken to ensure tube does not extend past the mother’s nipple so baby does not learn to suckle only the tube. The tube can be secured to the top, bottom, or either side of the areola – whatever garners the best result for baby. The tubing is typically inserted under the upper lip and enters the baby’s mouth along the roof of his mouth/palate.  However, some baby’s prefer the tubing to lie on the lower lip or along the tongue. Experimenting with what works best for you and your baby is key.

Baby Using Tube Feeding Device

Tubing can be secured to the breast with tape, if necessary.
Photo courtesy JoyfulAbode.com

The supplement can be initiated as soon as a baby begins to suckle at the breast, or the supplement could begin to flow after the breast has been drained. The tubing can be used in conjunction with a nipple shield.  For a baby with a weak suck, it is even possible to put the tubing from both sides on one breast so baby can receive an even larger quantity of supplementation while suckling at the breast. The flow of the supplement can be controlled by blocking and unblocking the flow of the tubing.

How Do You Clean the Tubing?

After each feeding, the tubing should be rinsed with cold water, then filled with warm, soapy water that is squeezed thoroughly throughout the tubing. This soapy water should then be rinsed well.  Once every day (24 hours) the tubing should be boiled for 20 minutes. 1

What are the Benefits of Supplementing with this Method?

As baby latches to breast, the tubing gently enters his mouth.

As baby latches to breast, the tubing gently enters his mouth.
Photo courtesy JoyfulAbode.com

At-breast tube feeding devices have many benefits:

  • Allows baby to continue nursing at the breast, rather than switching between bottle or other device which may lead to nipple confusion or breast refusal
  • Allows mother to breastfeed while supplementing with the added benefit of baby stimulating a mother’s milk supply while nursing
  • It is temporary aid to allow a mother to increase her milk supply while continuing to provide adequate nutrition to baby in a natural way
  • Mother can control rate of flow of supplement as well as starting the supplement later in the feed once breast has been emptied, or vice versa
  • A great option for mothers whose ultimate goal is to have baby nursing at breast
  • A great solution for mother’s who do not have enough breast milk to exclusively nurse but want their baby to experience full breastfeeding

When Should At-Breast Tube Feeding NOT be Used?

When a baby is not able to latch effectively to the breast, this type of nursing system is not very effective.  (In this case, working with a lactation consultant, it may be preferable to initially use finger feeding with the tube.) Babies can learn to suck the tubing, rather than the breast, in which case it does not help to stimulate a mother’s milk supply.  And when a baby is not able to generate sufficient suction at the breast, he will not be able to suck effectively enough to gain the nutritional benefit he needs.  If feeds take greater than 30 minutes, baby falls asleep during a feed, or if baby fails to gain adequate weight this type of feeding system is probably not the best option.2

Where Can You Obtain a Tube Feeding Device?

The supplement hangs in a pouch around mother's neck as baby nurses. Photo courtesy JoyfulAbode.com

The supplement hangs in a pouch around mother’s neck as baby nurses.
Photo courtesy JoyfulAbode.com

Two commercial tube feeding devices are sold in the US: SNS (Supplemental Nursing System) by Medela and Lact-Aid. Both can be purchased on-line and through many local doctors, hospitals, and lactation consultant offices.

The SNS by Medela has a firm feeding bottle, whereas the Lact-Aid has a soft plastic bag for the milk supplement.  The Lact-Aid requires a baby to suck against the flow of gravity as the tube exits from the top of the pouch. This may help to strengthen a baby’s suck, or it may be challenging for a baby with an already weak suck. 3

It is also possible to make your own at-breast tube feeding system. A gavage setup with a No. 5 feeding-tube or tubing from a butterfly needle can be used. 4

Show 4 footnotes

  1. Riordan, J. & Wambach, K. (2010) Breastfeeding and Human Lactation, 4th ed. Sudbury, MA: Jones and Bartlett Publishers, p.415.
  2. Wilson-Clay, B. & Hoover, K. (2008) The Breastfeeding Atlas, 4th ed. Manchaca, TX: BWC/KH Joint Venture, p.111.
  3. Wilson-Clay, B. & Hoover, K. (2008) The Breastfeeding Atlas, 4th ed. Manchaca, TX: BWC/KH Joint Venture, p.111.
  4. Riordan, J. & Wambach, K. (2010) Breastfeeding and Human Lactation, 4th ed. Sudbury, MA: Jones and Bartlett Publishers, p.415.
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