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Introduction
A lactation aid is a device that
allows a breastfeeding mother to supplement her baby with
expressed breastmilk, formula, glucose water with added
colostrum or glucose water without using an artificial nipple.
The early use of an artificial nipple may result in the
baby becoming "bottle spoiled" or "nipple
confused" because it interferes with the way a baby latches
on to the breast. Actually,
the baby is not confused.
The baby knows exactly what the score is.
If he goes to the breast and gets little milk and slow
flow and then gets a bottle with rapid flow, especially in the
first few days, most can figure that one out fairly quickly.
The
better a baby latches on, the easier it is for him to get milk, particularly
if the mother’s supply is low.
In the first few days, there is not a lot of milk, but
there is enough, if the baby gets what’s available.
But, because of a poor latch, 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 in the first week.
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. I do not
believe that the “newer bottles nipples” are any better than
the old ones. 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. And
there is more to breastfeeding than breastmilk.
Why is the lactation aid better?
1.
Babies learn to breastfeed by
breastfeeding
2.
Mothers learn to breastfeed by breastfeeding
3.
The baby continues to get your milk even while being
supplemented
4.
The baby will not reject the breast, which is very
possible if supplementing off the breast
5.
There is more to
breastfeeding than the breastmilk
What
is a lactation aid?
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 also available and are
easier to use in some
situations, but not necessarily.
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 two 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). (Use
should be shown by a person experienced in helping mothers with
breastfeeding)
1.
The baby may be latched on to the
breast first, and the tube slipped into the baby's mouth at the
appropriate time (after the baby has nursed on at least
both sides first).
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 it and 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, slightly
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.
2.
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.
3.
The tube may be taped to the breast if the mother desires,
though this is not really necessary and not always helpful.
4.
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 slightly
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.
5.
The bottle containing the
supplement should not
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 the doctor or lactation specialist suggests this.
6.
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. Better
eight supplements a day of 30 ml (1 ounce) per feeding than 2
large supplements a day of
120 ml (4 ounces) each.
7.
Do not cut off the end of the
tube. It works fine
as it is.
8.
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 30 ml of the
supplement.
9.
A trick for easier use:
Wear a shirt with pockets, and put the bottle in the
pocket.
Cleaning
the device
l.
Do not boil the tube of the non-manufactured aid.
It is not made to be boiled.
2.
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
1.
Maintain contact with the
breastfeeding clinic for advice about weaning the baby from the
lactation aid. See
the Protocol to Increase Breastmilk Intake by the
Baby.
2.
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 one or two weeks, and then levels out for a
variable period of time before decreasing.
The whole process may take two to eight 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.
3.
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.
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
#5. Lactation Aid. 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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