A supplemental nursing system (SNS) involves the use of a container or bottle, and a tiny tube leading from the container to the mother’s nipple. An SNS is used for supplemental circumstances when a baby either is not able to transfer milk from mother’s breast, or mother’s milk is in short supply. An SNS can be filled with expressed breast milk from the mother or a donor, or with infant formula.

An SNS may be recommended for a mother to use by a lactation consultant for specific reasons concerning the baby, or reasons concerning the mother. Some circumstances that may affect a baby’s latch including a premature baby, a baby with a cleft lip or palate, or a baby with Down Syndrome, would be perfect examples of when an SNS would be appropriate. A mother adopting a child who either wishing to induce lactation or create an intimate bond by breastfeeding their baby, a mother who has had previous breast-related surgeries, including augmentation, reduction, or removal of breast tissue for medical reasons, or a mother who congenitally has insufficient glandular tissue, would also be examples of which an SNS would offer a positive breastfeeding option.

The benefits of using an SNS versus a bottle for supplementation in the above situations, are both for the mother and baby. When a baby suckles directly on the breast, the baby is receiving nutrition from the mother’s milk supply directly, in addition to the tube. In this circumstance, the mother’s milk supply is stimulated hormonally by the infants suckling, and therefore helping increase her supply. In the event where mother either hormonally or congenitally is not able to produce a full milk supply for their baby, we must remember that breastfeeding is not only about providing mother’s milk to baby, it is just as much about creating and intimate bond, providing comfort, providing a safe place for baby and offering mother and baby a way to feed in the most natural approach.

Some quick tips:

• Before deciding to use a SNS, talk with an Internationally Board Certified Lactation Consultant (IBCLC). She/he will be able to give you advice on which system to use, and may be able to assess and improve position and latching. This will ensure that your breast is being stimulated properly, and will avoid sore and damaged nipples.
• If you have milk, use it! Talk with your LC and figure out when pumping is possible in your day to use your own milk in the device.
• Donor milk is available, but formula is ok too!
• Create a consistent routine with using your SNS. Decide what positioning is most comfortable for you (IE: placing in a pocket, hanging around your neck, having a partner or helper hold it), have a feeding area with all of your supplies (tape, water, cell phone) so that each feeding may happen with ease.
• Make sure the tube is positioned in baby’s mouth towards the roof of their mouth for consistent flow and comfortable swallowing. If your baby seems to be gagging or coughing or coming off the breast, slow the flow of the SNS and re-position the tube.
• Some mothers find it helpful to feed their baby with mittens or swaddled. This will prevent baby from tugging or pulling the tube out of their mouth. This is not the case in every circumstance, so make your best judgment during your feedings.

Remember that every task takes time to progress into ease. Take a deep breath, and remember that you are doing the best for you and for your baby. Reach out to your local LCs with all questions and concerns.
When you are beginning your journey of breastfeeding, remember that it is a special gift that only you can provide to your baby. If you need more support, take a breastfeeding class, come for a drop-in breastfeeding group, or talk to a lactation consultant on the south shore.