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      <h1 id="top">7.5.3 Finger Feeding</h1>
      <div>Finger feeding is an alternative feeding method when an infant is unable to breastfeed. It can also be used for modification of inappropriate sucking technique.<br /><br />Finger feeding may be used by the health professional and parents can very ably continue at home. It is seen as an alternative to cup feeding<sup><a href="#note1">1</a></sup> and a hospital study in Australia used finger feeding to substitute bottlefeeding in preterm infants who displayed faulty sucking techniques and found that it increased breastfeeding rates at discharge by 30% to 71%.<sup><a href="#note2">2</a></sup> <br /></div>
      <div class="section" id="When_to_consider_finger_feeding"><h2>When to consider finger feeding</h2>
    <div>Finger feeding may be considered:<br /><ul><li>the infant is unable to grasp the breast - affected by maternal medications during birth, trauma impairing cranial nerve function, tongue-tie, low tone conditions</li><li>the infant is refusing the breast<br /></li><li>mother has severely damaged nipples requiring rest during healing process - this is helpful to the mother and may also serve as a suck therapy for the infant during this time</li><li>as a 'pre-breastfeed' enticer for infants suffering from confusion or dysfunctional suck problems.<br /></li></ul>Finger feeding avoids the complications of bottlefeeding for a breastfed infant.<br />The feeder is able to feel the tongue action and respond with milk flow accordingly or stimulate the palate or tongue as required. The infant should be able to efficiently coordinate breathing and sucking if using this method.</div>
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      <div class="section" id="Preparation"><h2>Preparation</h2>
    <div>Infant to be ready for a feed<br />Infant supported on a pillow or on the lap of the feeder person.<br /></div>
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      <div class="section" id="Equipment"><h2>Equipment</h2>
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      <ul>
        <li>Syringe - regular or periodontal curved-tip OR soft feeding bag and feed line<br /></li>
        <li>Breastmilk or substitute at room temperature</li>
        <li>Pillow or towel roll</li>
        <li>Gloves (for all except infant's own parents)<br /></li>
      </ul>
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      <div class="section" id="Finger_feeding_technique"><h2>Finger feeding technique</h2>
    <div>The feeder controls the flow of milk according to the infant's sucking. The tip of the syringe is placed next to the feeder's finger, not pushing on the baby's mouth.<br /><br /> Be consistent in the technique used for finger placement, and utilize the same positioning principles as used when feeding at the breast: <br /> <ul><li> Infant well supported down the back </li><li> Infant's body in alignment with his head; neck slightly extended </li></ul> <br />The feeder washes hands -<span style="font-weight: bold;"> Note: health professionals to use a gloved finger</span>:<br /><ul><li>The feeder uses their finger with nail-side down and soft pad of finger to the palate.</li><li>The feeder's finger begins curled and uses the knuckle to stimulate the top lip and encourage tongue extension and gap. </li><li>Uncurl the finger under the top lip and introduce it along the palate.</li><li>Keep finger directly down midline during feeding.</li><li>Once sucking has commenced, insert syringe in corner of infant's mouth against the feeder's finger. Push very small aliquots of milk (approx 0.5ml) into infant's mouth to stimulate continued sucking.</li><li>Follow infant's lead with sucking bursts - only push milk in when infant is sucking, or stimulate suck recommencement by massaging the palate.</li></ul><span style="font-style: italic;">Note: if using soft feeding bag with feed line, place bag in palm of feeder's hand and tape tubing alongside gloved finger.</span><br /><ul> </ul></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>Important tip!</h3>
      <div>The infant oral cavity is very sensitive. Fingers come in all different shapes and sizes so to avoid confusion and desensitization of the infant, limit the number of different people who perform this procedure. Parents are very capable of taking on this task and teaching them will give them confidence.<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>
    <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/group.png" class="icon" alt="" /><h3>Finger feeding instruction sheet</h3>
      <div>Click on this <img alt="PDF" src="design/page_white_acrobat.png" /><a href="http://www.saskatoonhealthregion.ca/pdf/bcs_finger_ffeeding_oral_syringe.pdf"> hospital information page</a> for parents on finger feeding. <br />Does your unit or practice have an information sheet like this? If not, research the topic further and produce your own.<br /></div>
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    <div class="section" id="Teach_finger_feeding"><h3>Teach finger feeding</h3>
      <div id="slideshow_0" class="slideshow">
        <div class="captionBox"><img width="454" height="461" src="images/gape_response_crop.jpg" alt="Step 1 - Stimulate gape and uncurl finger onto tongue." /><p>Step 1 - Stimulate gape and uncurl finger onto tongue. <br />&copy; B.Ingle IBCLC</p></div>
        <div class="captionBox"><img width="455" height="341" src="images/finger_feed_crop_BI.jpg" alt="Step 2 - Introduce syringe tip alongside finger keeping finger down midline of palate and infant's head slightly extended." /><p>Step 2 - Introduce syringe tip alongside finger keeping finger down midline of palate and infant's head slightly extended. <br />&copy; B.Ingle IBCLC</p></div>
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      <div id="footnotes">
        <h3>Notes</h3>
        <ol>
          <li id="note1"><a href="references.html#marm00" title="See full details">#</a> Marmet C et al. (2000) Assessing infant suck dysfunction: case management.</li>
          <li id="note2"><a href="references.html#oddy03b" title="See full details">#</a> Oddy WH et al. (2003) Implementing the Baby Friendly Hospital Initiative: the role of finger feeding.</li>
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      <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>7.5.1 <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 class="current">7.5.3 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><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>
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