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An at-breast supplementer is a device used by breastfeeding mothers to provide supplementation to their infants while initiating or continuing breastfeeding. It consists of a container , fitted with a tubing(s), which is inserted into the infant’s mouth along with the nipple/areolar complex as s/he latches onto the breast. The device is filled with the supplement (expressed breastmilk, human donor milk or synthetic infant formula). As the infant suckles from the breast s/he is also provided with the extra supplement.

:: Picture an auxiliary fuel tank ::

The ideal flow rate should provide the infant with sufficient supplement to provide optimal growth while still allowing the infant to provide sufficient stimulation to the mother’s breast in order to increase mother’s own milk supply. See the supply and demand regulation of breastmilk.

At-breast supplementers are used in the following situations:

Mother doesn’t have an adequate milk supply to meet her baby’s needs Infant needs fortified milk (increases of certain components)
  • Very low birth weight infant may need increased protein, minerals and calories
  • Cardiac baby may need increased calories while restricting fluids
Infant has a problem accessing the milk that is available in mother’s breast
  • Weak baby
  • Baby with oral/facial abnormality that precludes effective and/or efficient breastfeeding
  • Infant has abnormal suckling pattern that is ineffective and is corrected by the reinforcement of a steady fluid flow
    • Prefers fast flow that s/he may be used to from bottle use in the past
    • Infant is unable/unwilling to suckle actively while waiting for the letdown (nuero-hormonal response that increases the immediate flow of breastmilk from the mother

The following are types of at-breast supplementers:
  • Specifically manufactured for this purpose
  • SNS(regular or starter)
  • Lact-Aid
  • Supply Line
  • XXX (I need to look up another name – will correct soon)
  • Found to be useful for this purpose but manufactured for another purpose
  • Periodontal syringes
  • Medical tubings of various sorts hooked to syringes or placed in receptacles of supplement
    • Tubings may be infant gavage tube
      • #5 French gavage tube preferred
      • a piece of intravenous tubing
        • butterfly IV needle with attached tubing and needle part cut off – only tubing portion is used
        • Jelco IV needle sheath – needle removed
        • Small syringe without a luer lock and with a smooth, elongated tip
        • Medical grade dropper device with a smooth, elongated tip

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