A common concern we encounter is that of babies not gaining weight as expected. A beautiful Mum , Eve, has generously documented her journey of providing extra milk to her baby using a technique that is not commonly discussed – a supplemental nursing system (“SNS” or “supply line). This is a means of supplementing or “topping up” baby with additional milk whilst they are feeding at the breast. In this case fit and hold had been optimised but baby Hazel was still not gaining weight. Here is their story:

“Shortly after Hazel was born with the support of the regular home visits with FMC midwifery group practice and initial health checks with Dr Rhiannon Smith, we noticed that it was taking longer than expected for Hazel to return to her birth weight. With some close monitoring and commencing regular appointments with Dr Rhiannon Smith for lactation consults I was provided with some options which included the supply line.

Hazel would fall asleep at almost every feed, she would rarely stay awake long enough to have a good feed. It seemed as though she just didn’t have enough energy to feed effectively and I appeared to have a low supply. I started expressing with a pump or Haakaa and providing the expressed milk to top up during a breastfeed via the supply line.

Initially I felt very defeated that we were experiencing issues with breastfeeding and weight gain. I was continually conflicted with what I wanted to achieve with breastfeeding and whether I was doing enough for my baby.

In the beginning I started to introduce small top ups of expressed breast milk in bottle form but knew that time away from the breast could start impacting my supply. After regular weighs there was limited weight gain which was very disheartening. It was recommended that the top up quantity and frequency be increased. I started using the supply line so that I could keep Hazel at the breast and have some control of her intake. We started to increase the top up amount and offered this top up to every feed.

I was so determined to make the whole breast feeding thing work but seeing your baby not putting on weight as easily and fast as you’d like can make the whole beginning of motherhood pretty stressful and second guessing all of your choices.

Hazel took the supply line well, she would get so sleepy on the breast that it was great to know she was getting an adequate intake before falling asleep.

I was able to express from the unused breast and feed from the other. Whilst she was feeding I would be able to slide the supply line tube in the side of her mouth. Hazel was able to continue feeding from the breast and get the extra top up without compromising my milk supply.

Tips and Tricks for using a SNS

-Making sure to use a line/tube that still encouraged Hazel to suck. The larger the line the easier the milk would drain out.

-On occasions if I was distracted, I’d notice the line had slipped out and milk would be leaking out.

-It can be a bit fiddly but eventually it became second nature. Tucking the bottle under my chin or in my bra strap. Knowing just the right position to place the tube into her mouth without getting any blockage to the flow of milk.

-Having the support of my husband who would prepare the warmed milk into the supply line whilst I got comfortable with baby to start the feed and then would clean it after it was finished, ready to use again in 3 hours.

– I was also supported to find appropriate fitting breast pump flanges. I would never have known I needed to purchase a size that was not offered by the manufacture, and that pumping with incorrect fitting flanges meant I was almost unable to express any milk.

Pros and Cons of the SNS

The extra cleaning, and double handling of my milk. Expressing, storing and then preparing the supply line. Cleaning the tubing of the supply line, it was a process to ensure the line was clear of milk.

Using the supply line in public, I didn’t want to be bound to being at home waiting for the next feed. I was happy to bring it out to friends places etc. But I imagine that’s not for everyone.

Being able to know that my baby was getting a decent feed, and also not compromising my milk supply was the most beneficial part of the supply line. Seeing that Hazel was starting to put on weight was such a relief.

The supply line became a security blanket, and it took me some time to reduce the use. But eventually Hazel got stronger and was a more efficient feeder, we were able to stop using it and breast feed without it. 12 months and still going strong.