Tuesday, January 4, 2011

Lact-Aid Demo: In which I take one for the team and bare it all for the greater good.

If you're a mother who found herself struggling with either supply issues or your baby's serious latch issues, you might have needed to supplement, whether with your own pumped milk, whenever possible, donor milk, or, if neither is available, formula. With getting back to exclusive breastfeeding as a goal, if you were getting informed support from a reputable source, you may have been advised to try an at-the-breast supplementer, such as a Lact-Aid or an SNS (the "supplementary nursing system" by Medela) in order to avoid the pitfalls of using a bottle too early, nipple/flow confusion in particular. Finger- or cup-feeding are also frequently recommended by good lactation professionals, and are great in the short term, but some mothers occasionally need to supplement for longer while their supplies are established or their babies suck coordination is improved.

But without adequate instruction - and good demonstration - these supplementers seem devilishly complicated to the point of maddening, and understandably, many mothers get fed up with trying to figure them out. A search online for a decent YouTube video turns up a few Jack Newman offerings. I have the utmost respect for Jack Newman, and the information he makes available is incredibly valuable - but to be brutally honest, these supplementer videos are of little to no use to a mother who is trying to figure the damned thing out, and in particular, how to get their baby latched using the supplementer all by herself, which is going to be the reality for 99.9% of all moms out there. He's doing it all FOR her. It's nice to show it in action, and promote its benefits, but not helpful at all in learning HOW.

Moveover, the way he pushes the tubing into the baby's mouth after the latch is established is completely impossible to do if you're using a Lact-Aid instead of an SNS (which I do strongly recommend; more on that later), because its tubing is so much softer than that of the SNS. This is one of the reasons a Lact-Aid is preferable in the first place, but you MUST put the tubing in at the same time the baby latches on.

So, I'm taking it upon myself. Pretty much literally. Why? Because I believe so strongly in supplementing at the breast whenever supplementing is needed, whenever it is possible. In addition to the way supplementers circumvent nipple confusion, it also makes it possible for mothers who have supply issues to increase the amount of stimulation, and thus production, their breasts are getting. (Regular pumping sessions may still be advisable for a while - please consult an IBCLC about this if it is your own situation - but why not kill two birds with one stone? Pumping and supplementing is hard enough.)

And perhaps most importantly but more challenging to quantify, it IS breastfeeding, and will help to improve baby's latch (again, see IBCLC for advice on how to monitor this) AS you are feeding, whereas with a bottle, even slow flow and/or "breast-like" bottles like the Breastflow, one can only cross one's fingers and hope too much damage to baby's technique isn't done. Using paced feeding and an upright position helps, but it's challenging.

This is also personal: The Lact-Aid made it possible for us to make the transition to the breast after struggling for months, and I firmly believe we never would have made it without it.

An important note: I mentioned that there are two major types of supplementers out there, the Lact-Aid and the SNS by Medela. I have used both, and FAR AND AWAY, I feel that Lact-Aid is the superior product. I write about this in our nursing story, but in a nutshell: It is much, much more user-friendly in several ways, including the way you wear the bags around your neck, the fact that no taping is necessary, and the fact that the tubing itself is very soft and shouldn't disturb baby at all - they probably won't even notice, especially if they're newborns. I started using it when Lily was 4 months old and she was fine, whereas the harder tube of the SNS makes many a baby balk. YES, it's true, I also have ethical issues with Medela, but I promise you I felt this way long before I learned of some of Medela's questionable practices.

Make no mistake: if you choose to use the Lact-Aid, and I sincerely hope you do if supplementing is necessary, there is still going to be a learning curve. I cannot tell a lie: the first few days are pretty much gonna suck. But every feeding is practice, and within a few days, you'll start to really get the hang of it. And in a week or possibly two, it'll be down pat. To be honest, for the first couple of days, I only did Lact-Aid feeds a few times a day, during the times when Lily (and her mom) was at her 'best', i.e. not in the middle of the night. And then I gradually added more Lact-Aid feeds in. You might want to try phasing-in this way, too. Take it one feed at a time.

OKAY. Without further ado, here's a very short video, starring my boob and the baby of one of my clients, with whom I became friendly. I actually had been donating some milk to her privately as a result (she had breast reduction surgery years ago, and like some, though not all, BFAR moms, had to supplement a bit). I also occasionally babysat, and we mutually decided, Well, if she's getting my donated milk anyway, why not offer it from the tap?

Let me be clear: this isn't exactly an official extra service I regularly offer to clients, it just kind of worked out that way. I had worked with them on using the Lact-Aid, too, and one day, after struggling with descriptions and coaching, I said hey, since I've nursed her anyway, would you mind if I simply showed you on myself? She was totally fine with that, and so I did. It was IMMEDIATELY much easier for her. And then it occurred to me that, due to the dearth of existing videos it might be helpful for the internet masses to see as well. She offered up her beautiful little one for me to film (isn't she precious?), and here we are, our other kiddos chattering in the background.

There you have it. Please, in the comments, ask me about anything that needs clarifying, or anything to do with the Lact-Aid. One thing I can think of right off that merits a bit more explanation: If you want to start off the feed with milk from the breast and add the supplementation at the end, which is preferable, you can either delatch and relatch, or, even easier, as I demonstrate, simply start the feed with the tubing pinched off in one of the notches in the body of the Lact-Aid device, then, when babe's sucking slows down, release the tube from the notch and the supplement will start to flow. Oh. and one other note, the bag of milk is hanging kind of low here - you can adjust the strap so it's much higher, and you can nurse in lots of different positions.

Again, feel free to deluge me with questions.

Somehow I knew it would just be a matter of time before, one way or another, I showed my boobs on the internet. But here it's for a noble purpose, right? RIGHT? If it convinces even one mom go with the Lact-Aid instead of a bottle, or instead of tearing her hair out with an SNS - and then giving up and going with the bottle, it is all worthwhile.


When I shared this with my own LC, Jennifer of Intuitive Parenting Network, she quoted my statement, "Because I believe so strongly in supplementing at the breast whenever possible, any time supplementing is needed," and said "I am allowed to smile, right?"

I feel it's only fair to point out what she's getting at, which is that when faced with doing this myself, I fought it tooth and nail. I talk about this in the link to our nursing story I posted towards the beginning, but I think it's worth repeating here as well. Yeah, I literally resisted using this for months. MONTHS. My experience trying to use an SNS at about 6 weeks was just so indescribably awful that I desperately wanted to avoid using anything like it ever again if I could. So I kept pumping around the clock and bottlefeeding my milk to Lily. I was using the upright "paced" technique, and I would try various ways to offer the breast before, during, after, and in-between feedings, but I was still bottlefeeding her. And was really making little to no progress towards our goal. Treading water is all it really amounted to, and driving myself nuts with frustration in the process.

Jennifer, and other moms in our support group who had trod the Lact-Aid path tried many times to convince me that the Lact-Aid was going to be a much different, much better experience, and more importantly, because I was at a total standstill in progress with the bottlefeeding, it would likely be the one thing that got me over the hump. And they were absolutely right about both things. If I had tried using the Lact-Aid earlier than I did, I could have started nursing her many weeks, even months earlier than we finally did. No exaggeration.

People often commend me for sticking it out the 5 months it took to get Lily nursing, and I appreciate that and do take it in, but honestly, the stubbornness that I tapped into to get her ON the breast is the same stubbornness that made me resist using the Lact-Aid, and therefore held up our progress much longer than was probably necessary. I just had to get to the end of my rope, my absolute wit's end, the point where I was truly on the edge of just giving up altogether and EPing for her. I was trying to figure out how I could make my peace with this decision, and I realized that the only way I would ever be able to be okay with giving up on breastfeeding is if I truly KNEW that I had tried everything. And the Lact-Aid was the final frontier. If things didn't work after that, then I would be able to forgive myself, knowing that I had done my very honest best. But only then.

So I took the proverbial deep breath and threw myself into it. And it was tough for a few days, but after that, grew progressively easier - and I saw progress. Real progress. Within 3 weeks she was only taking about 2 ounces per day from the supplementer (I used it at every feed, but only released the flow of the tubing when she was starting to slow down). I kept using it for another week, just to be on the safe side, but really, we had made it. We had crossed over. And it was totally the Lact-Aid - and those who convinced me to try it - that did it.

I'm grateful beyond words that Jennifer can now smile at my stubborn ass. If you're facing anything similar to what we faced, any variation on it - look, DON'T follow my example. Don't torment yourself for months, fearing that breastfeeding will be impossible for you, out of fear of some frustrating feedings and having to learn a new technique. Supplementing at the breast is a godsend in the right situation. Just do yourself a favor and use the superior product, commit to overcoming the learning curve (because you WILL), and go for it. I'm rooting for you!


  1. Thanks for this post and video Anne! (And baring your boob on the Internet for a good cause!) I have a feeling I'll be using this in the future to help LC clients learn to use supplementers.

    At the hospital we always always use a supplementer if at all possible. We often use an improvised system with a 10 cc syringe and a 5 french feeding tube. The tube is definitely stiff enough to push into the baby's mouth but also sometimes leads to the baby rejecting the supplementer because they don't like the feel. The SNS tube is definitely softer, and it sounds like the LactAid is even better.

    Out of curiosity, what were your/your LC's thoughts on finger feeding? At the hospital, if the baby won't latch, we'll generally do a spoon feed or syringe feed - easy with the small volumes of colostrum. The LCs I have trained with are fairly anti-finger feeding. As one says "You can imitate a bottle with a nipple shield and an SNS, but nothing feels like a finger" - i.e., if babies get nipple preferenced to a bottle there are solutions but if they get used to the finger, there's trouble. I guess the advantage of finger feeding is that it's harder to create a flow preference (vs. the fast flow of a bottle) but paced bottle feeding does solve some of that issue. What was your experience?

  2. Thanks for sharing, Anne! Your video will be valuable to many moms. You may also want to do one showing you setting up a Lact-Aid if you get the chance. Many moms become overwhelmed with the set up process until they get used to it. You story is very inspirational and I know many moms will benefit!

  3. Rebecca, yay, I hope you do find it useful professionally! On finger-feeding: It's complicated. I think for short-term use it's fine, and better than bottle introduction. But it's not meant to be long-term, and I think that when it goes on for more than a few days, exactly what your instructors describe can happen. I *think* that Jennifer would probably say the same thing. Temporarily, it does no harm, which is sometimes all you're going for. The problem is that there's not necessarily any guarantee that the problem will clear up in as short a time as one hopes. In most cases, with good support, it will, but sometimes not. Case in point: me.

    Just to be specific, the kind of finger feeding I did (for about 6 weeks - WAY too long) was with a syringe dispensing the milk. One thing I did, convincing myself it would help attune Lily to the normal flow of milk directly from the breast, was try and simulate a 'letdown': I would depress the stopper very slowly at first, and only when (I thought) she was suckling properly - the main problem with that 'suck training" theory was that she literally COULDN'T, and I didn't know the difference at the time. Still, it was being depressed when she was trying, at least. Anyway, after a minute or two, I would increase the flow. I thought this way it would prevent her from expecting instant gratification once we transitioned to the breast. Maybe it helped a LITTLE, but it mostly made me feel like I was doing something proactive, something to make some real progress toward the breast. Which has value, too.

    So yes, I do agree that finger-feeding has its pitfalls.

    Melissa, I probably should do just that! I think I DID see a video online of how to set one up, unlike videos on how to use it WITHOUT having Jack Newman there to assist you. :O) But maybe I'll do my own anyway. I can totally, 100% understand being overwhelmed by the whole process; my approach was to be absolutely methodical and pretty much OCD about it - I would always set up the Lact-Aid for the next feed IMMEDIATELY after pumping; if I let that get away from me, it's way too easy to get scattered and sidetracked and forget to clean the parts and on and on.

    Do you think it would be helpful to have a post with the whole routine? I meant to do a post on pumping and how I would set up the glider as both a pumping and nursing "station" so everything was all right there, and made life as easy as possible (i.e. still fracking hard as hell, but manageable one day at a time). Maybe I'll film the assembly and put a post together on all of it, if you think it would be useful?

  4. YES PLEASE! That would be SO helpful.

    Oh, hi, by the way. Long-time reader, first-time caller. I am a new doula on Vancouver Island, Canada, focusing on post-partum work. I am working with a mom who is expecting to have to do some supplementing, pumping, etc.

    This video was extremely helpful as were your comments about the Lact-Aid. I personally used the SNS and, while I hated pumping and supplementing, I do think the SNS saved our nursing relationship. (I didn't know about the Lact-Aid at that time).

    Thank you for the amazing blog. I have learned so much from you.

  5. bnh, way to make my day! I wish you had been able to use a Lact-Aid instead. It's still work, to be sure, but definitely a big difference. I hope the video will help your new mom, too! No doubt you'll be the biggest help for her, with your own experience to draw upon.

    I'll get working on the setup demo as soon as I see my client next, then. Pleased to make your acquaintance!

  6. Can I just say that you look about 14 in that pic (in other words, you look lovely and happy) I know it was a very, very tough time for you and sweet Lily...but you pulled it off like a rock star. I just recommended this post to a momma with supply issues (from surgery) and hope that she has the kind of success that you did!

  7. THANKS Justine! I hope it helps her! Feel free to send her my way with questions. And make sure she's taking goat's rue above all!

    And also - whaaaa? :O) If you mean the top pic, that's not me. It's from the Lact-Aid site, which I linked it to. (I try to send as much traffic their way as I can.) But I appreciate the thought!

  8. THANK YOU for making this!!!

  9. Fantastic piece! As an IBCLC, I'll definitely be sharing this ... a lot! Thanks so much!

  10. LOVE this. I did not even know about SNS (or Lact-aid) when we were trying breastfeeding - and you'd think that as a mom of a preemie who had been pumping from day one, some lactation consultant, nurse, ANYONE would have said something in the hospital!

    I tried the medela SNS as a last ditch effort to get my preemie to breast (long after we'd gone home from NICU) after hearing about it on TWITTER. It was confusing and since we were having latch issues as well, very difficult to handle. You made it look so easy, but you had the latch down pat.

    I'm getting ready to quit EPing for my son - it's been 20 months now ;) I'm so glad you put this up for other moms to find, so they don't HAVE to pump and bottle feed for 20 months!

  11. Thanks for putting this out into the world!

    As a 4-month SNS (actually it's a hazelbaker finger feeder that we are using as an SNS on the advice of our bf med doc because the flow is faster, but same process) veteran, I wonder if you have any thoughts on getting "stuck" on these devices?

    Our son was born with a severe tongue tie (required 3 frenotomies) and compressions in his neck and jaw, so he had a poor latch/suck and we started supplementing through the SNS due to his lack of weight gain. I pumped when I could but mainly it ended up being formula in the SNS (because SNS plus newborn PLUS pumping? OMFG something had to slide).

    We didn't introduce a bottle at the beginning since we were dealing with so many issues, and I still hoped to breastfeed. So now when we try he will barely let the bottle into his mouth and pushes it out with his tongue and won't swallow anything from it.

    At this point his latch is great but we are still using the SNS because my supply went down. Yes, we have had some nice breastfeeding moments but overall if I could snap my fingers and be able to bottle feed I would do so. Our life is extremely limited.

    I really don't "get" what the end point is here. Our OT (at the infant feeding center at children's) recommends a bottle intensive where I leave for a day and my husband gets our son to take a bottle, but honestly that sounds so traumatic to me that I have been putting it off.

    Anyway, sorry to write a novel, I am just distressed (writing this in the middle of the night in bed after pouring formula and setting up the SNS) and frankly sick of the SNS (though I completely recognize how critical and wonderful these devices can be as a tool in the short term!) so I would love to hear any thoughts you might feel like sharing on "exit strategy"

    Lots of love and appreciation ~ Eileen

  12. Hi Eileen! I feel ya, out there in the midst of it, trust me. I totally do. I know what you mean about not knowing what the end point might be. One of my focuses in school will be EXACTLY this, helping women to transition OUT of using the various aids that are sometimes advisable. It's tricky, and far from an exact science!

    I do have some (non pro, peer-to-peer) thoughts: Did he ever have any bodywork? Physical therapy, chiropractic, anything to not only deal with the compressions but also integrate the clippings? If not, it still might help.

    It sounds, though, like the concern is more about your supply now that he's actually latching, and getting it up to meet his demand. Are you doing anything to boost it, like pumping (first and foremost, though I know it's a chore) and galactagogues? And are you working with an LC in any capacity, even just checking in occasionally or visiting a support group?

    I wish you luck - will check back on this thread!

  13. Thank you so much for this great post! I'm an adoptive breastfeeding mom and I had quite the love/hate relationship with my Lact-Aid for the months that we used it!
    I've added a link to this page from my blog page where I give my two cents and tips from my experience using at breast supplementers:

  14. I'm also a momma through adoption and have used the SNS (this time; also used it 4.5 months with my now 5yo)) for more than 9 months. I really do hate the thing - mostly that I can't nurse him laying down - but I appreciate that it allows/allowed me to have this special relationship with my boys. I originally was going to use the lact-aid, but I was given the SNS in the hospital and got used to it. By the time we got home from hospital, the lact-aid looked really overwhelming to try to figure out, so we've stuck with the SNS. Both boys have always taken it without any problem, probably because we've never nursed without it. Thanks for this post - it would have been helpful 5 years ago :)

  15. Oh wow, I'm so glad I found your blog!!! My daughter is 6 weeks old and I have had low milk supply all this time. By week 2 , I broke down and gave her a bottle which filled me with regret. Much like you, I would still offer the breast whenever I could and pump whenever I could, which all seemed like a downward spiral. As of one week ago, I started supplementing at the breast and what a difference! The first 3 days were awful, but now it's not so bad and I can see the light at the end of the tunnel! My question to you is, if I continue on this path, how long do you think I will have to use the lact- aid? Thanks for sharing your wisdom, for all of us!!

  16. I truly believe that the concept of a tool that allows you to supplement at the breast is amazing, and had it not been so trying and tiring to use, it may very well have saved my breastfeeding relationship.

  17. I've have been trying to relactate for months now with no success getting my six month old to latch. I ordered the Lact-aid and have frustrations with getting the tube to stay in place. I had a recommendation from an LC to tape the tube down and then tape a nipple shield on top of it. What do you think? As my baby is getting older, I am running out of motivation.

  18. This is incredible and I applaud you! I first used the Lact-Aid 30 years ago, with my first adopted baby. I essentially nursed him part time for a few months. I was very afraid of having anyone know that I was doing it. I'd heard of families being rejected as adoption applicants because the wife had expressed an interest in breastfeeding and someone said that it was a sign that she was mentally unstable and wanted to pretend that she had given birth to the baby. I won't go into the details of each, but I eventually adopted six babies. My success was limited with my first two, but the last four, including one who was six months old, gastrostomy fed, and antisocial when I got her, all weaned when they chose to at between 20 months and four years.

    I used the Lact-Aid with all of them, for at least 10 months. I first saw the SNS with my third baby. I thought it looked like it might be easier than the Lact-Aid but when I tried it I found it more difficult. Since I had used the Lact-Aid before, I made myself use SNS, alternating it with the Lact-Aid, so I could get a good idea of how it worked. Despite that, Lact-Aid was the one I preferred, by far.

    I get so frustrated when I see moms who are producing little or no milk, get the Lact-Aid one day, and by the next day are saying that they have tried and tried, but they just hate it! I tell them that it is up to them, but that if they really want to establish a long-term breastfeeding relationship, they should take a deep breath, take suggestions from other moms, and hang in there. But, some won't do it. If things worked out well for them, that would be one thing, but virtually always what happens is that it isn't long before they are just bottle feeding. If they WANT to bottle feed, that is fine, but if they really want to breast feed, I'm willing to keep trying to encourage them, no matter how long it takes! Pretty much everyone who sticks with it will soon have a day when they have it down and can do it in the dark! I've done everything, including filling them, with only a night light on and without putting down the baby. One of the main reasons I preferred it was that I could get set up to nurse with it without putting down the baby, which was much more difficult with the SNS. In the middle of the night, the more the baby cried, the more likely it was to wake one of my other children.

  19. This is day 5 of using the Lact-aid for me and my new born, we were turned on to the product by you, Anne, after I had an appointment with you at the breastfeeding center. At this point, it's still very frustrating! Even when we have a good latch with the tube in place, the milk does not flow! I know it's not clogged because I test it myself, it seems like the tube has to be in such a perfect position for the flow to come through the tube, not to mention it takes us 4-5 times just to get the baby and the tube on my boob while his arms are flailing around or his head is shaking back and forth in search of my nipple. I am going to try to use tape on the next feeding because it just seems like getting the tubing in the right position is proving to be very difficult. I AM very thankful that my baby has not had a bottle and I'm sure I will eventually get used to the Lact-aid as I am almost positive I will never have enough supply to fully breastfeed, but I guess I just needed to voice my frustrations because it really isn't easy yet! Any suggestions or helpful tips would be great, I have an appt next week at birthingway so maybe they can help me.

  20. HI there! I am hoping I'll get to give you some hands-on assistance when you come in. There is DEFINITELY still a learning curve, and I for sure want to check out the positioning. Serious kudos to you for being willing to stick it out!!!

    Which day are you coming in? Don't see it on the calendar but I could be looking in the wrong place.

  21. Hi Anne,

    I am in the lower mainland and I wonder if you know where I might be able to buy the lact-aid in Canada? I really want to buy one asap as my three week old daughter is dependent on bottles right now because I have very low milk supply. Thank you!

  22. I was also wondering if you know where you can buy them in Europe ..I really need it fast and being in Denmark I think it will take too long ftom the states ..would really love a reply

  23. I don't know off the top of my head, honestly! But I would go ahead and contact the company directly - I'm sure they would be able to tell you what would be the best route, who might carry them in Europe, etc. Good luck to you!

  24. Hi Anne just to let you know ..I ordered it at midday on Friday and it arrived to my door in Copenhagen at 6pm Monday evening. .excellent service..... l was wondering did you ever make a video of how to assemble it or how easiest/best way to clean it.
    I did make one mistake when ordering .. I bought a refrigerator storage rack and some extra bag clamping rings thinking that we could premake at least 5bags but now it has arrived it has become clear you need as many training units to be able to store the bags ..I was wondering if you had a solution without having to buy more ..as the import tax was half the price of the whole purchase. When you look at the picture of the storage rack it's very difficult to see this ...hope this helps others ..tak tak

  25. I could have written this post, as I am on this same vicious cycle of pumping and bottles! I started using Lact-Aid almost a week ago, and wish I hadn't waited this long to start. I don't know how much my supply has increased, but I have been pumping 3 oz in a single night session for 3 nights in a row now - something I was never able to do before!

    My question for you: what kind of pumping schedule did you have when you started the Lact-Aid? Previously I was starting my baby at the breast and then bottle-feeding while I pumped, so roughly pumping 8 times a day. Now I'm pumping 4 times a day and using Lact-Aid for all her feedings. I can't seem to find time for more pumps. Do you think this is sufficient?