Introduction
A lactation aid
is a device which allows a breastfeeding mother to supplement her baby
with expressed breastmilk, formula or glucose water with added
colostrum (glucose water alone should only be used, in general, in the
first day or two after birth) 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. 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 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)
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.
This article may be copied and
distributed
without further permission
 About the
Author
JACK NEWMAN
graduated from the University of Toronto medical school as a pediatrician in 1970. He
started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's
Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly
Hospital Initiative in Africa, and has published articles on the subject of breastfeeding
in Scientific American and several medical journals. Dr. Newman has practiced as a
physician in Canada, New Zealand, and South Africa.
|
Breastfeeding
All
About
