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Supplementary feedings are defined as feedings provided instead of a
breastfeeding. These feedings usually consist of expressed breast
milk or formula. The Academy of Breastfeeding Medicine has released
Hospital Guidelines for Use of Supplementary Feedings in the Healthy
Term Breastfed Neonate.
These guidelines should help health care
personnel decide when supplementation is needed for term breastfed
newborns.
There is a lot of debate in the literature about nipple confusion
(
Neifert, 1995
).
Nipple confusion is most commonly defined as infants
who have been fed from an artificial nipple and then have difficulty
"with exhibiting the correct oral configuration, latching technique
and suckling pattern to extract milk from the breast."
Infants who are sick or who need special care may need
to be separated from their mother.
Concern has been raised about giving these infants a bottle
and having them get attached to the bottle and then not wanting to go
back to breast.
Other techniques are thus considered for feeding term babies
who cannot breastfeed:
- Nasogastric (NG tube) feeding.
- Finger feeding uses a feeding tube taped to a finger at one end
and to a syringe of milk at the other end.
The baby sucks on the feeding tube and the finger (
Wight, 2001
).
- In cup feeding the infant laps milk
from the edge of a small cup being held by the care giver
(
Kuehl, 1997
,
Lang, 1994
, and
Wight, 2001
).
Healthy term 1 to 3 day old infants have been shown to
maintain physiologic stability
during cup feeding and to ingest a similar amount of milk compared
to infants fed from a bottle (
Howard, 1999
).
Howard and coworkers compared the
effect of supplementary feeding of hospitalized newborns using a
cup or a bottle on the duration of breastfeeding. When more than
2 supplemental feedings were given by a cup compared to a bottle,
cupfeeding prolonged the duration of exclusive and full
breastfeeding (
Howard, 2003
).
- If the mother is available to nurse and the infant needs more milk,
a supplemental nursing system may be very effective.
This consists of a holder for milk and a small tube leading to the breast
and nipple.
The baby can suckle at the breast,
stimulate the mother's breast milk production and additional formula can
be given.
The baby is rewarded for suckling by getting breast milk and formula.
This may encourage them to suck more effectively which will increase
prolactin and the breast milk supply.
This can prevent hypoglycemia in an SGA infant.
It may also work well with mothers' whose infants are jaundiced
but whose milk supply is not "in yet."
This increases oral intake.
It can also be used for infants who have poor weight gain.
Supplemental nursing systems
Supplemental nursing systems can be purchased or constructed using a feeding
tube and a 10cc syringe
(
Edgehouse, 1990
).
A supplemental nursing system made from a 10cc syringe and a feeding tube
Photo courtesy of and Copyright Wellstart International.
Used With Permission.
A supplemental nursing system in use.
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