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The Supplemental Nursing System (SNS) is a device used by breastfeeding mothers to provide at-breast supplementation to their infants. It consists of a rigid bottle, fitted with a size matched pair of flexible tubings (one for each side) that are individually 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) and hung with the tubings facing downward from an adjustable string around the mother’s neck. As the infant suckles from the breast s/he is also provided with the extra supplement in the SNS.

The flow from the SNS can be regulated to provide more or less supplement in a set period of time. The device comes with 3 sets of tubings with different inner diameters and therefore different flow rates. Other actions can also be employed to vary the flow rate. Flow rate is influenced by gravity as well as the strength of the infant’s suckle.

These things increase the flow rate:
  • Warming the supplement
  • Raising the height of the bottle
  • Opening the opposite (not in use) tubing
  • Using a larger tubing size
  • Using both tubings in the infant’s mouth at the same time, this method should be used with extreme caution, may cause extremely fast flow that could overwhelm the infant
  • moving the tip of the tubing ¼ inch beyond the tip of the mother’s nipple

These things decrease the flow rate:
  • Not warming the supplement
  • Lowering the height of the bottle
  • Clamping the opposite (not in use) tubing
  • Using a smaller tubing size
  • Using a single tubing in the infant’s mouth
  • pulling the tip of the tubing back so it is shorter than the tip of the mother’s nipple

There is also a Starter SNS with a smaller bottle that clips onto clothing and with a singel tube. Flow rate can only be controlled by raising and lowering the starter SNS so its use is limited.
manufactured by Medela and can be seen at www.medela.com

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