Breastfeeding Supplementation Using an SNS
Your baby is alert, bright, and already the apple of your eye. Either at your two or your six week appointment, the doctor announces that the baby has not gained an appropriate amount of weight and will need to be supplemented. From what you have read, you know that supplementing almost always diminishes your breast milk supply. The doctor insists that you must supplement - your milk is inadequate to provide the necessary calories for good brain development. This, you muse, is why so many mothers give up breastfeeding at six weeks.
This is exactly what happened to me. My baby boy, a beautiful seven pound 13 ounce boy at birth doubled his birth weight by two weeks, as most babies do. He was flourishing on my milk. He had hit every single growth and development milestone. Then, at his six week appointment, I was told he had not gained enough weight. My son was averaging about 2.5-3 ounces a week, instead of the 4-8 ounces that the "experts" claimed was needed for good development. The doctor said I needed to supplement, with a bottle, after I offered him my breast.
The SNS could very well save your breastfeeding experience.
Sometimes you need to look beyond medical advice.
I refused. I informed the pediatrician that I would seek the counsel of a lactation consultant. After all, my mother had successfully breastfed ten children, including multiples. My son was meeting all his milestones and was happy. The doctor spoke threateningly to me basically stating that I was starving my baby. I compromised saying that if his growth hadn't improved by his 2 month, then we could talk about supplementing with a bottle. That gave me roughly 2.5 weeks to get him to gain a minimum of 10 ounces. I called the lactation consultant, who had me increase my water intake to 120 ounces a day, take Brewer's Yeast, and basically nurse as often as possible.
My son did gain the 10 ounces, but the doctor decided that wasn't good enough. My son was under the 5th percentile on the growth chart. She repeated the need to supplement with a bottle. I had asked the Lactation Consultant for a list of questions. I asked the doctor if we could agree to treat the baby, not the scale. My baby was making all his milestones. The lactation consultant speculated that he was hypermetabolic, so giving him extra calories wouldn't hurt. After asking my questions, it suddenly dawned on the doctor that maybe this had absolutely nothing to do with my milk, the calorie intake, or the internal workings of my baby. She sent us for blood work. Low and behold, my son was anemic (unsurprising as I am chronically anemic) and another doctor said he was probably hypermetabloic based on family history.
Breastfeeding success starts with a well-informed momma.
With the counsel of the lactation consultant, the doctor and I finally agreed to give my son 10 ounces of iron fortified formula a day, delivered through a tube system called a Supplemental Nutrition (or Nursing) System (SNS). He would latch on for breastfeeding and I would insert the tube in his mouth. He would still have to suckle and nurse, but he would receive additional vitamins, minerals, and calories through the SNS. 10 ounces would be 4 feeds, as the bottle with the SNS was 2.5 ounces. It was incredibly easy. As babies need about 30 ounces of milk a day, I was only giving him about one third of his nutritional needs in formula.
My son gained an entire pound in a week and a half after starting the SNS. He nursed just as often as he was before. I was still pumping about the same amount. The plan is: once he gains an appropriate amount of weight, we will slowly replace the formula with breast milk in the SNS. Once the SNS is only supplementing breast milk, we will cut down on one feeding per week until he is only breastfed. This will likely take place around 4-5 months. He will receive a multivitamin with iron daily once we have begun weaning him off formula.
The success of breastfeeding my son was vitally important to my husband and me. We were not willing to compromise our child's health or nutrition for our want of breastfeeding. We were willing to research, ask questions, and challenge the doctor. I am so thankful for the knowledge of lactation consultants and the existence of the SNS. If you experienced poor weight gain while breastfeeding, contact a lactation consultant!