At-the-Breast Supplementing

Using a feeding tube at the breast to help a baby learn to nurse at the breast can be a helpful tool but also a tricky thing to learn to use. Babies learn how to breastfeed best by being at the breast. But will you have the most stimulation at your breast by using a supplementer or by pumping and bottle feeding or by a little of each?

Mixing with HOT water

Mixing with HOT water

This can be a TEMPORARY solution in the early weeks and should have a plan for both starting and weaning off or cutting down on supplementation. Or this may be a LONG TERM solution for moms with low supply from specific situations such as thyroid challenges, breast reduction or mammary hypoplasia/insufficient glandular tissue among other reasons.

It is important to know that the first thing you will want to do is speak with an International Board Certified Lactation Consultant to help you make up a plan of use. It may be that simply getting help with latching on the breast is what you need.  They are the highest credentialed person qualified to help you in your situation and for your goals.

It may be that you don’t really need to supplement at all? See:

Perceived Insufficient Milk?

It may be that you are trying to re-lactate because you weaned and want to retry to nurse. Or perhaps you have adopted or had a surrogacy or other situation that leads you to want to try to breastfeed. There are plenty of great reasons to nurse your baby at the breast!

It may be that your baby was born with a special need, low muscle tone, tongue tie, cleft palate or other physical circumstance that they need a little extra help in getting nursing going. This can be a temporary help or a permanent tool for you.

Your situation makes your plan individual. It may be that you supplement with Mom’s/Parent’s Own Milk (first choice) or with donor milk or formula. You will need to work on how much and how often with your IBCLC and baby’s health practitioner. When you use human milk, you can easily warm it on your own body when using the tubing. If you use formula, you may need to be sure to keep it from clumping a little in the tubing. Please understand using formula safely

An IBCLC can also make suggestions on the best way to use the supplementer and where to position it well so baby can latch on your breast and not just sip from the tubing like a straw. If you are working on getting a baby to work harder as they nurse, you may lower the container at times during the feeding. But, if you are working at getting a baby with low muscle tone, thin fat pads in their cheeks or down syndrome to nurse at the breast, you may want to raise the supplementer up a little to let gravity help your baby out at some points during the nursing session. This should all be worked out in a feeding plan for your situation with an IBCLC and your baby’s pediatrician.

Two wonderful books that are helpful for using a supplementer and working on milk supply are:

The Breastfeeding Mother’s Guide to Making More Milk by Diana West and Lisa Marasco.

Breastfeeding Without Birthing by Alyssa Schnell.

Some considerations for you…

Is this for home or use out and about as well? Take it one day at a time.

Will you need more than one set of kits/tubing? Cost is a factor.

How comfortable are they to use? There are varying tubing sizes and equipment that is soft or hard.

Is at-breast supplementing helping to support proper suckling & latch? Is baby latching well when using the tubing?

Is the at-breast supplementer helping you in your positions to nurse – laid-back, side lying, clutch hold, etc?

Cleaning… time/tools required?

Support – an IBCLC, friends, family?

Taping? Using bandages to hold tubing in place or surgical tape – in baby’s way or irritating to skin?

Wearing under clothing or over clothing? Or with a cover or without?

Mobility of containers – bottles with lids, hard plastic or soft? Keeping supplement safely stored while out and about.

Cost – short term & long term $ and emotional.

Here are some great websites for tips on comparing brands and daily use.

At Breast Supplementers (and adoption)

Dr. Newman Lactation Aid (buy your own tubing and use any container for milk)

Dr. Newman – inserting lactation tubing while nursing

Know that it takes some practice to use a supplementer and not every situation is right for them to be used in. For example, if you are working on supply because your baby isn’t latching well at the breast or staying on strong enough, then the supplementing can be a nice way to help them learn WHILE AT THE BREAST but you will still need more stimulation via a breast pump or other means of expression so that you keep giving your baby the right milk making signals for the time when baby IS strong enough to nurse without being supplementing. On the other hand, you may have exhausted all means of working out your supply and know how much you need above what you are making and this is the situation that you are considering long term… then you may find that supplementing at the breast is a way to cut down on other pumping/expressing. The bottom line is you know your body best!

And what if you do have low milk supply?

Check out the books I mention above! I can’t say enough good things about them!!

Low Supply – links

I’m Worried My Milk Supply is Drying UP – What Can I Do?

Are There Differences Between Breastfeeding Directly And Bottle-feeding Expressed Milk?

Brands – you can buy some of these or simply make your own by buying the tubing. Ask at your local birth center/hospital about local options for buying tubing. Know that you can simply buy quality food grade or medical grade tubing and make your own versions, especially if you are thinking in terms of short term use.



Other links for supplementing:

Tools for Feeding: Bottles & More

Bottle feeding the breastfed baby… paced and baby-led bottles.

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1 Response to At-the-Breast Supplementing

  1. I love this list! Thanks for putting it together.
    I’ll certainly be checking out the ones I’m not familiar with, and sharing with my doula clients. (And thanks for including my video. Glad you liked it! 🙂

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