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Using a Lactation Aid
Introduction
A lactation aid is a
device that allows a breastfeeding mother to supplement her baby with
expressed breastmilk, formula or 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,
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. 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. And there is more to
breastfeeding than breastmilk.
Why is the Lactation
Aid Better?
babies learn to
breastfeed by breastfeeding
mothers learn to
breastfeed by breastfeeding
the baby continues to
get your milk
the baby won't reject
the breast
here is more to
breastfeeding than 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 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 -- Use should be shown by a person experienced in helping
mothers with breastfeeding)
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, 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.
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 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.
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 the doctor or lactation specialist suggests this.
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 8
supplements of 30 ml (1 ounce) per feeding than 2 large supplements
of 4 ounces each.
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 30 ml of the supplement.
A trick for easier use:
Wear a shirt with pockets, and put the bottle in the pocket.
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, and
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.
Handout #5. Lactation
Aid. Revised January 2003
Written by Jack Newman,
MD, FRCPC. © 2003
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