The supplemental nursing system (SNS) is relatively unknown until you need it. We receive many consultations on using a supplemental nursing system (SNS) as a supplementation method during breastfeeding. When we think of a system to supplement milk to a baby, the first thing that comes into mind is usually a baby bottle. So, we have talked in another article about the different types of supplementation methods, and today, we focus on the supplemental nursing system (SNS) and answer the main questions you may have about it:

What is a supplemental nursing system (SNS)?

The supplemental nursing system (SNS) is a device with two basic parts: a recipient and a tube. In the case of a purchased supplemental nursing system (SNS), the recipient has a cord that allows it to be hung around your neck so it doesn’t get in the way and stays more or less above your breasts. This way, if the supplemental nursing system (SNS) is higher, the milk will flow more easily through the tube. If, on the other hand, it is lower, then the baby will have to use more force to suck and get the milk out.

Commercial supplemental nursing systems (SNS) also offer different tube sizes with more or less flow so that, depending on the baby’s situation, milk can be offered more or less quickly.

The tube is placed on the breast and fits over the nipple so that the baby, when latching onto the breast, has it in the mouth and can suckle both, the breast and the contents of the container.

When can it be used?

Supplemental nursing systems (SNS) can be used in a wide range of situations:

• In the case of a relactation (get back to breastfeeding after introducing formula)
• In the case of induction of lactation for an adopted baby or for the non-birthing partner in same-sex relationships
• When a baby is not gaining enough weight, and it is needed to offer more milk
• When the mother has hypoplastic breasts and cannot achieve exclusive breastfeeding
• In general, whenever a baby can suck effectively and needs to be supplemented with either breast milk or formula.

When should it not be used?

First of all, it should not be used if the mother is not comfortable or confident with its use. To use the supplemental nursing system (SNS), you need to learn the basic user technique, know how to insert it into your baby’s mouth, and how to control the baby’s rhythm. It also adds complexity, and many families are uncomfortable with its use when they are outside their homes.

On the other hand, for babies who have weak or immature sucking, are premature or sick, and lack in strength, a supplemental nursing system may not work well for them because they must suck hard to get milk and may not succeed, get tired, and then don’t feed enough.

Advantages and disadvantages of using a supplemental nursing system (SNS)

This is the only milk supplementing method that stimulates and encourages babies to breastfeed. It also allows the mother to do two things at the same time: breastfeed the baby and offer extra milk, either expressed breast milk or artificial milk.

Among the disadvantages is that the baby can get used to the tube and may reject the breast when the mother does not use it.

There are some babies who get used to feeding only from the tube. They learn to suck from it as if it were a straw and finish the contents of the supplemental nursing system (SNS) in a few minutes, which is not convenient and does not fulfill the function for which the supplemental nursing system (SNS) is intended.

Are there any tricks I need to know?

It is recommended that you use the small or medium-sized tube all the time while using the device. The wider tube is only used when the baby rejects the breast, and we want to show the baby where the milk comes from so that they are encouraged to suckle.

It is also highly recommended to keep squeezing the tube so that the baby does not get used to sucking only from the tube. By intermittently pressing the tube, you can imitate the variations in milk flow that the baby would notice if feeding from the breast alone.

Can I use breast milk or formula milk interchangeably?

Yes, there is no problem with using one or the other. It can be previously pumped breast milk so that the baby will be feeding only breast milk and suckling at the breast at the same time, or commercial formula milk, which is called mixed or combi feeding.

However, it is important that the milk does not exceed 37 degrees Celsius (98.6 degrees Fahrenheit). In the case of pumped breast milk, you only need to warm the milk a little in another container with hot water.

In the case of commercial formula milk, because it has to be mixed with water at 70ºC (158ºF), it is better to reconstitute it in another container, remove any lumps, and then transfer the milk to the supplemental nursing system container.

Does it have to be sterilized after each use? How do I wash it?

No, you don’t need to sterilize it. Just clean the container thoroughly before the first use. However, the tubes tend to get quite dirty, so cleaning the supplemental nursing system immediately after each use is very important.

Disassemble the device piece by piece and then clean it thoroughly with soap and water.

The tubes usually acquire a dull color. You can use a little bit of citric acid in the cleaning process, and then you can avoid limescale deposits, but then all parts must be thoroughly rinsed.

Allow the supplemental nursing system to dry on a clean, dry cloth before you reassemble it again.

How can I place the tube with nipple shields?

If you use nipple shields, you should still stick the tube directly to your breast with adhesive tape, place the tube a few millimeters outside of the nipple, and then place the nipple shield on top of it. To make the nipple shields stick more easily and not move, you can use vegetable oil or, if you have some, lanolin cream.

When can I stop using it?

This depends on your needs and preferences. Some mothers use it during the entire breastfeeding journey, others use it for some time, and others use it only for a few days or weeks. Only the evolution of your breastfeeding journey and your needs and preferences can define how long you should use it.