Introduction
Finger feeding is a method that helps train the baby to
take the breast. It
can also be used to avoid artificial nipples, but its primary
purpose is to help latch on a baby who refuses to latch on. (See handout #26 When a Baby Refuses to Latch
On). If
you want to breastfeed successfully, it is better to avoid the
use of artificial nipples before your milk supply is well
established. Finger
feeding may be used if:
1.
The baby refuses the breast for whatever reason, or if the baby
is too sleepy at the breast to nurse well.
It
is also a very good way to wake up a sleepy baby during the
first few days of life.
2.
The baby does not seem to be able to latch on to the breast
properly, and thus does not get milk well.
(However, if a lactation aid can be used at the breast,
why use finger
feeding?).
3.
The baby is separated from the mother, for whatever reason.
However, in such a situation, a cup is probably a better
method of feeding the baby.
4.
Breastfeeding is stopped temporarily (there
are very few
legitimate reasons to stop breastfeeding. See
handout #9a and #9b, You
Should Continue Breastfeeding).
5.
Your nipples are so sore that you cannot put the baby to the
breast. Finger
feeding for several days may allow your nipples to heal without
causing more problems by getting the baby used to an artificial
nipple. Cup feeding
is also more appropriate in this situation and takes less time.
This is only a last resort.
Proper positioning and a good latch help sore nipples far
more frequently than finger feeding (Handout #3, Sore
Nipples). And a good all purpose nipple ointment will help more.
This so called “nipple holiday” is usually a mistake
and if suggested within the first few days of life is a terrible
mistake. Taking the
baby off the breast does not always result in painless feedings
once you start again, and sometimes the baby will refuse to
latch on.
Finger feeding is much more similar to breastfeeding than
is bottle feeding. In
order to finger feed, the baby must keep his tongue down and
forward over the gums, the mouth wide open (the
larger the finger used, the better), and the jaw
forward. Furthermore, the motion of the tongue and jaw is
similar to what the baby does while feeding at the breast. Finger feeding is best used to
prepare the baby who is refusing to latch on to take the breast.
It should be used for a minute
or two, at
the most, just before trying the baby on the breast if the baby
is refusing to latch on. Cup feeding is usually easier and faster when the mother is not
present to feed the baby and is better to finish the feeding, if
finger feeding is slow.
Please
Note: If
the baby is taking the breast, it is better
by far to use the lactation aid tube at the breast, if
supplementation is truly necessary (See handout A: Protocol
to Increase Breastmilk Intake by the Baby, and handout #5, Using a Lactation Aid). What
sense does it make to finger feed after breastfeeding?
Finger
feeding
(best learned by watching and doing)
1.
Wash your hands. It
is better if the fingernail on the finger you will use has been
cut short, but this is not necessary.
2.
It is best to position yourself and the baby comfortably.
The baby's head should be supported with one hand behind
his shoulders and neck; the baby should be on your lap, half
seated, and facing you.
However, any position which is comfortable for you and
the baby and which allows you to keep your finger flat
in the baby’s mouth will do.
3.
You will need a lactation aid, made up of a feeding tube (#5F,
36" long), and a feeding bottle with expressed breast milk,
sugar water, or if necessary, formula, depending on the
circumstances. The
feeding tube is passed through the enlarged nipple hole into the
fluid.
4.
Line up the tube so that it sits on the soft part of your index
(or other) finger. The
end of the tube should line up no
further than the end of your finger.
It is easiest to grip the tube, about where it makes a
gentle curve, between your thumb and middle finger and then
position your index finger under the tube. If this is done properly, there is no need to tape the tube
to your finger.
5.
Using the finger with the tube, tickle the baby's lips lightly
until the baby opens up his mouth enough to allow your finger to
enter. If the baby
is very sleepy, but needs to be fed, the finger may be gently
insinuated into his mouth.
Pull the baby’s lower lip out if necessary.
Generally, the baby will begin to suckle even if asleep,
and receiving liquids will then usually awaken him.
6.
Insert your finger with the tube so that the soft part of your
finger remains upwards. Keep
your finger as flat as possible, thus keeping the baby’s
tongue flat and forward. Usually the baby will begin sucking on
the finger, and allow the finger to enter quite far.
The baby will not usually gag on your finger even if it
is in his mouth quite far, unless the baby is not hungry or he
is very used to bottles.
7.
Pull down the baby's chin, if his lower lip is sucked in.
8.
The technique is working if the baby is drinking. If feeding is very slow, you may raise the bottle above the
baby's head, but usually this should not be necessary.
Try to keep your finger straight, flattening the baby's
tongue. Try not to
point your finger up, but keep it flat.
9.
The use of finger feeding with a syringe to push milk into the
baby's mouth is, in my opinion, too difficult for the mother to
do alone and definitely not
more effective than simply using a bottle with the nipple hole
enlarged and the tube coming from it.
The idea of finger feeding is not to feed the baby!
The idea is to train the baby to suck properly, so
pushing milk into his mouth defeats the whole purpose of finger
feeding.
If you are having trouble getting the baby to latch on to
or to suckle at the breast, remember that a ravenous baby can
make the going very difficult.
Take the edge off his hunger by using the finger feeding
technique for a minute or so.
Once the baby has settled a little, and sucks well on
your finger (usually only a minute or so), try offering the
breast again. If
you still encounter difficulty, do not be discouraged.
Go back to finger feeding and try again later in the feed
or next feeding. This
technique usually
works. Sometimes
several days, or on occasion a week or more, of finger feeding
are necessary, however.
If you are leaving the hospital finger feeding the baby,
make an appointment with the clinic within a day or so of
discharge. The
earlier the better.
Once the baby is taking the breast, he may
still require the lactation aid to supplement for a period of
time. Although the
baby may take the breast, the latch can still be less than
ideal, and the suckle may still not be efficient enough to
ensure adequate intake.
Questions?
(416)
813-5757 (option 3) or drjacknewman@sympatico.ca or
my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate
Breastfeeding Book of Answers in
the USA)
Handout
#8.Finger Feeding. Revised
January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further
permission,
on the condition that it
is not used in any context in which the WHO code on the
marketing of breastmilk substitutes is violated.
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