<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<!--Generated at Mon, 20 Aug 2012 17:49:29 +1000 HEXML processor version: 2642-->
  <head>
    <meta name="author" content="Denise Fisher" />
    <meta name="course" content="ES01" />
    <meta name="topic" content="7.5.1" />
    <meta http-equiv="content-type" content="text/html; charset=utf-8" />
    <meta name="copyright" content="2012 Health e-Learning" />
    <meta name="robots" content="NONE,NOARCHIVE" />
    <meta name="cache-control" content="NO-CACHE" />
    <link rel="stylesheet" href="design/hexml.pack.css?v=1345448969" type="text/css" />
    <script type="text/javascript" src="design/hexml.pack.js?v=1345448969"></script>
    <title>Feeding-line device at the breast</title>
  </head>
  <body>
    <div id="access">
      <a href="#access" accesskey="a">Access Keys</a>
      <a href="#menu" accesskey="m">Skip to Menu</a>
      <a href="#content" accesskey="c">Skip to Content</a>
      <a href="#footer" accesskey="f">Skip to Footer</a>
    </div>
    <div id="content">
      <h1 id="top">7.5.1 Feeding-line device at the breast</h1>
      <div>
    <p> There are various types of feeding-line devices commercially available; they can also be improvised. The supplemental milk is contained in a soft pouch or bottle, and a length of fine, soft tubing reaches from the milk receptacle to the breast at the nipple/areolar complex. </p>
    <p> As the baby suckles at the breast, milk is removed from both the breast and the feeding-line device. This is an excellent method of providing supplemental milk. It avoids any possibility of suck confusion, stimulates the mother's breastmilk production, enhances the infant's suck vigor by creating a steady milk flow and lessens the likelihood of breast refusal when supplementation becomes necessary. <br /></p>
    <p>Unlike any other form of supplemental feeding method, the at-breast supplementer will never compromise the mother's milk supply and in most circumstances, it will enhace milk supply or stimulate supply to achieve the highest possible production in the individual mother.<br /></p>
  </div>
      <div class="section" id="When_to_choose_an_at-breast_feed_line"><h2>When to choose an at-breast feed line</h2>
    <div>An at-breast supplemental feed line provides a constant flow of milk to the infant while he suckles on the breast. The infant will draw milk from the breast and the supplementer at the same time. It may be very useful for:<br /><ul><li>newborn requiring supplementation for medical reasons<br /></li><li>mothers with a chronic low supply (ie. due to infant poor feeding or conditions such as hypoplasia)</li><li>failing to thrive infants who are still willing to breastfeed</li><li>infants with low tone (primary hypotonia or secondary due to underfeeding)</li><li>some cases of breast refusal in the older infant who is frustrated with a slow milk flow</li></ul><br /></div>
    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><img src="design/tip.png" class="icon" alt="" /><h3>Clinical tip</h3>
      <div>Insufficient milk flow will very quickly cause the infant to lapse into non-nutritive sucking or display breast refusal behaviour. <br />Newborns imprint that the breast is the place which provides all their needs. An at-breast feed line can rescue a breastfeeding relationship which is threatened by poor infant-breast association. Consider a feed line as a first choice rather than a last resort. Become proficient with it's use so that you can confidently assist mothers.<br /><br />Does your unit use any feed lines? Practice with a 'home-made' version using a syringe and naso-gastric feedling tube and organise to purchase a demonstartion kit which mothers would use at home for longer term supplementing.<br /></div>
    </td><td class="middleright" style="background: repeat-y url(design/callout_06.png);"><img src="design/callout_06.png" width="10" height="80" alt="" /></td></tr></tbody></table>
  </div>
      <div class="section" id="Equipment"><h2>Equipment</h2>
    <div>
      <ul>
        <li>the feeding line device, ready-to-use</li>
        <li>hypoallergenic tape</li>
      </ul>
      <span style="font-style: italic;">Note: an improvised feedline can be may with a 10/20ml syringe and a premature infant naso-gastric tube. Cut off the diffusion holes at the end so milk flows only out of one hole. The tube may be placed alongside the nipple as usual with kit feeding line.</span>
      <br />
    </div>
  </div>
      <div class="section" id="Preparation"><h2>Preparation</h2>
    <div>
      <ul>
        <li>Warm the milk to be used as a supplement.</li>
        <li>Prime the tubing with the supplement milk, either by gravity or by vacuum (suction). </li>
        <li>Tape the distal end of the tubing to lie alongside the mother's nipple, with tape away from where baby will latch. The tubing is best placed on the breast to be just above the corner of the infant's mouth, not in the middle of the top lip.<br /></li>
      </ul>
    </div>
  </div>
      <div class="section" id="Technique"><h2>Technique</h2>
    <div>
      <ul>
        <li>Latch the baby as usual, ensuring the soft tubing passes into baby's mouth as he latches to the breast. (Instruct the mother to visualise that the tubing will be running alongside the length of the nipple so it sits in the groove of the tongue during sucking.<br /></li>
        <li>Breastfeed as usual.</li>
        <li>
          <p class="listTitle">Milk flow can be controlled by</p>
          <ul>
            <li>raising the milk container; the flow of the supplement is easier to initiate and requires less suction to maintain flow, </li>
            <li>lowering the milk container; the flow will be slower, requiring greater suction from the baby, or</li>
            <li>clamping the tubing off initially, encouraging baby to remove as much breastmilk from the breast as possible before unclamping the supplement.</li>
          </ul>
        </li>
      </ul>
    </div>
    <div class="captionBox"><img width="455" height="341" src="images/sns_BI.jpg" alt="At-breast supplemental feeding line." /><p>At-breast supplemental feeding line. <br />&copy; B.Ingle IBCLC</p></div>
  </div>
      <div id="footer"><a href="topic_7-5.html" rel="prev" class="prev">&laquo; Previous</a><a href="topic_7-5-2.html" rel="next" class="next">Next &raquo;</a><br style="clear: both" /><a href="#top" id="topLink">Back to top</a><a href="javascript: window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2012 Health e-Learning<p class="printOnly">COPYRIGHT: You are permitted to print ONE (1) copy for your personal use only. No graphics, tables, quizzes, videos, etc, may be used in any form without express written consent. Author: Denise Fisher</p></div>
    </div>
    <div id="menu">
      <h1>Breastfeeding Essentials</h1>
      <ol>
        <li>1.0 <a href="topic_1-0.html">Why Breastfeeding is Important</a><ol><li>1.1 <a href="topic_1-1.html">Biochemistry</a></li><li>1.2 <a href="topic_1-2.html">Immunology</a></li><li>1.3 <a href="topic_1-3.html">Relative risks</a></li></ol></li>
        <li>2.0 <a href="topic_2-0.html">Communication Skills</a><ol><li>2.1 <a href="topic_2-1.html">Non-verbal</a></li><li>2.2 <a href="topic_2-2.html">Listening skills</a></li><li>2.3 <a href="topic_2-3.html">Building confidence</a></li><li>2.4 <a href="topic_2-4.html">An example</a></li></ol></li>
        <li>3.0 <a href="topic_3-0.html">Pregnancy Care</a><ol><li>3.1 <a href="topic_3-1.html">The feeding decision</a></li><li>3.2 <a href="topic_3-2.html">The barriers</a></li><li>3.3 <a href="topic_3-3.html">Physical preparation</a></li></ol></li>
        <li>4.0 <a href="topic_4-0.html">The Birth Experience</a><ol><li>4.1 <a href="topic_4-1.html">The first hours</a></li><li>4.2 <a href="topic_4-2.html">Labor interventions</a></li><li>4.3 <a href="topic_4-3.html">Postnatal interventions</a></li></ol></li>
        <li>5.0 <a href="topic_5-0.html">Breastfeeding the Baby</a><ol><li>5.1 <a href="topic_5-1.html">Positioning Principles</a></li><li>5.2 <a href="topic_5-2.html">Breastmilk transfer</a></li><li>5.3 <a href="topic_5-3.html">Assessing breastfeeding</a></li></ol></li>
        <li>6.0 <a href="topic_6-0.html">A time to learn</a><ol><li>6.1 <a href="topic_6-1.html">Practical skills</a></li><li>6.2 <a href="topic_6-2.html">Breastfeeding messages</a></li><li>6.3 <a href="topic_6-3.html">Normal growth</a></li><li>6.4 <a href="topic_6-4.html">Sleep</a></li><li>6.5 <a href="topic_6-5.html">Psychological support</a></li><li>6.6 <a href="topic_6-6.html">Discharge planning</a></li></ol></li>
        <li>7.0 <a href="topic_7-0.html">Infant Challenges</a><ol><li>7.1 <a href="topic_7-1.html">Late preterm infant; Non-latching</a></li><li>7.2 <a href="topic_7-2.html">Hypoglycemia; Jaundice</a></li><li>7.3 <a href="topic_7-3.html">Supplementation</a></li><li>7.4 <a href="topic_7-4.html">Crying baby</a></li><li>7.5 <a href="topic_7-5.html">Inadequate weight gain</a><ol><li class="current">7.5.1 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><a href="topic_7-5-1.html">Feeding-line device at the breast</a></li><li>7.5.2 <a href="topic_7-5-2.html">Cup feeding</a></li><li>7.5.3 <a href="topic_7-5-3.html">Finger Feeding</a></li><li>7.5.4 <a href="topic_7-5-4.html">Bottle feeding</a></li></ol></li></ol></li>
        <li>8.0 <a href="topic_8-0.html">Maternal Challenges</a><ol><li>8.1 <a href="topic_8-1.html">Engorgement</a></li><li>8.2 <a href="topic_8-2.html">Nipple Pain</a></li><li>8.3 <a href="topic_8-3.html">Breast Problems</a></li><li>8.4 <a href="topic_8-4.html">Insufficient breastmilk</a></li><li>8.5 <a href="topic_8-5.html">Medical, Surgical Issues</a></li></ol></li>
        <li>9.0 <a href="topic_9-0.html">Promotion, Protection and Support</a><ol><li>9.1 <a href="topic_9-1.html">The International Code of Marketing of Breastmilk Substitutes</a></li><li>9.2 <a href="topic_9-2.html">The Baby Friendly Initiative</a></li><li>9.3 <a href="topic_9-3.html">Young Child Feeding</a></li><li>9.4 <a href="topic_9-4.html">Local initiatives</a></li><li>9.5 <a href="topic_9-5.html">Infant feeding in emergencies</a></li></ol></li>
        <li>10.0 <a href="topic_10-0.html">Closing session</a><hr /></li>
        <li class="appendix"> <a href="references.html">List of references</a></li>
        <li class="appendix"> <a href="contents.html">Course contents</a></li>
        <li class="appendix"> <a href="full.html">Print version</a></li>
      </ol>
    </div>
  </body>
</html>
    </ol>
    </div>
  </body>
</html>
