What is a Supplemental Nursing System?
A supplemental nursing system (SNS) is a special device that allows a breastfeeding parent to supplement babies with milk bank donor breast milk or formula while latched onto the breast.
An SNS consists of two main components, a bottle or reservoir for supplemental milk and a long, thin tube, usually 5 French in diameter (1.67 mm diameter, 5.24 mm circumference), that is submerged in the milk on one end, and on the other end is attached with medical paper tape at the breast so that the tube can be inserted into a baby’s mouth as they latch onto the nipple (or snuck into the corner of their mouth after they’re latched).
The tube can be clamped while getting the baby to latch to avoid spillage. Once the baby is latched, the tube can be released from the clamp to start the flow of milk. The baby’s own sucking will draw out milk from the reservoir.
This allows the baby to spend extra time at the breast getting supplemental milk, which helps them to learn how to latch effectively and reinforces the association of getting milk at the breast; this is especially important for mothers with insufficient breast milk supply who wish to continue direct breastfeeding.
The SNS also provides additional stimulation to the breast; this maximizes the release of hormonal signals that encourage milk production within the mother’s capacity to produce milk. However, it must be used correctly, as some babies learn to use the tube as a straw and thus do not provide sufficient nipple stimulation.
It is important that the SNS reservoir and tubing are cleaned immediately after use according to the manufacturer’s instructions to prevent bacterial growth and contamination of milk.
Using a Supplemental Nursing System (SNS):
Step 1: Assemble SNS according to manufacturer’s instructions, or alternatively make your own SNS using the many designs found online (be sure you are using a 5 French diameter tube).
Step 2: Fill the reservoir or bottle with human milk or formula and either clip it to your shirt, or place it in your bra for stability.
Step 3: Using surgical tape or a band-aid, tape the tube to your breast, with the end of the tube reaching the end of your nipple, or a little past it. (If a clamp is included in your kit, clamp the tube until your baby is latched to avoid spillage.)
Step 4: Latch your baby.
- If you are using a nipple shield, put it on after the tube is in place.
- If you have difficulty latching your baby with the tube attached to your breast, alternatively you can latch the baby first, then slip the tube into the corner of their mouth while they are latched.
Step 5: Unclamp the tube so milk can flow. If the milk is not flowing, you may need to insert the tube farther into the baby’s mouth; usually about ¾ to 1 inch of the tube enters the baby’s mouth.
Step 6: Clean and sterilize your SNS. It is critical to make sure any small parts and the feeding tube are cleaned after every use, dried as well as possible, and sterilized once a day. Bacteria grow very easily and quickly in the moist environment of feeding tubes.
Cleaning Tip: Hold the end of the tube in your hand and swing it around quickly several times; centrifugal force (like the spin cycle on your washing machine) will draw water out of the tube and allow it to dry.
Expert Tip
When adhering the adhesive bandage to the desired place above your nipple, keep the center section free (where the gauze bandage part is), so the tube can simply slide under. This will allow the bandage to stay attached and permit multiple feedings without removing the bandage.
The Bottom Line
Using an SNS takes practice, so be patient with yourself and your baby, and consider using a bottle when you are feeling stressed or exhausted. If the SNS works for you and your baby, it can be a great tool that you both enjoy using, and if it doesn’t, there are many other tools you can use to facilitate breastfeeding.
To learn more about this topic, read the Fed Is Best book available on paperback, e-book, and audiobook.