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Supplemental Nursing Systems


When it comes to feeding your baby, many people seem to think you only have 2 options - breast/chestfeeding or bottle feeding. Whilst your options are human milk or formula milk, there are multiple delivery systems available. One of those options is a Supplemental Nursing System.


What is a Supplemental Nursing System (SNS)?

The most basic explanation for an SNS is that it is a container with a straw.



[Image description - basic outline drawing of a cup with a lid and a straw.]


Why use an SNS?

There are many reasons for using an SNS - low milk supply, non-gestational/non lactating parent feeding, delay in milk coming in etc


How to use an SNS

The ‘container’ is filled with human milk or formula, the ‘straw’ is then attached to the ‘container’ on one end and taped alongside the feeding person’s nipple with low adhesive tape. Then, depending on the system you are using, you can hold the container in your hand, place inside a bra or tight fitting top, pin it to your clothing or even wear around your neck.


[Image description: Person wearing a black tshirt with the phrase 'some people are trans'. They are wearing a SNS device around their neck. Their face is not visible]



Where can I get an SNS?

You can quite easily purchase one online. They cost around £40 so they're not exactly cheap. Alternatively, you can make your own.


How to make an SNS

There are a number of ways you can make an SNS. The thing you’re most likely to need to purchase is a feeding tube.


Container options - You will only need one container (BPA FREE)

Bottle (vented bottles tend to work best)

Sippy cup with soft teat

Milk storage bag Syringe (smaller syringes are better for premature babies)


If you are using a bottle or sippy cup, you’re better off with a smaller one around 150ml as you won’t take up too much of the feeding tube length.


Feeding tube options - You want this to be about a metre in length

4FR Polyurethane feeding tube 5FR Polyurethane feeding tube


You might be able to get some feeding tubes and syringes from your local hospital if you ask nicely. Otherwise, you can buy them online quite easily. Because the tubes are not made from silicone, they ought to not be reused but use your best judgement. It is possible to clean them


Tape options (LOW TACK)

Micropore surgical tape

Plaster

Masking tape

Parcel tape


Micropore is generally the best tape to use. It's recommended that you try different tapes on your chest in advance to check for allergic reactions. You may also need to remove any hair from the area directly next to your areola as the tape may tear it out.


You shouldn't need to warm up the milk as your body heat should keep it at the right temperature. However, you may need to let it come up to room temperature before wearing it next to your skin!



Using a vented bottle


As you can see from the image below, the feeding tube goes into the vent. I find it easiest to go from the inside, squeeze the vent open, insert the tube, pull it through to the outside then pull it back so the valve is flat. If you're using a tube with a feeding port, ensure that the port is open. The weight of it should help it stay at the bottom of your container.


The reason I recommend using a vented bottle is because the straw goes in much easier through the vent. If you are going through the teat, the hole may split and become ragged which can be a breeding ground for bacteria.


You may wish to set it up then sterilise it before use.


The bottle needs to be above the nipple and gravity will assist with the flow. You do not need to tip the bottle. If the flow seems a little fast, you can pinch the tube to slow it down.


[Image description: Small vented baby bottle with a feeding tube coming out of the vent and attached to a rainbow crocheted breast]


Using a milk storage bag


One of the benefits of using a milk storage bag is that it's pretty much ready to go. You just need to get your 'straw' in place and seal it up. Most milk storage bags have a zip loc function that may help to keep the 'straw' in place. The main pitfall of using a milk storage bag is it's not solid and could easily spill.



[Image description: Milk storage bag with zip loc top and a feeding tube coming out of the top. The end of the feeding tube is taped along a yellow knitted breast with a pink nipple]



Using a syringe


A syringe is best used for smaller feeds owing to the capacity of the device. Hospitals might be willing to give you a number of syringes for harvesting milk/colostrum. These can be frozen or refrigerated and then simply clipped into the feeding tube when needed. It is recommended that you remove the plunger from the syringe and let gravity do it's thing. Alternatively, you can gently depress the plunger as your baby is feeding.




[Image description: Syringe connected to a feeding tube taped to a rainbow crocheted breast]



If you need to "wear" your SNS device, you can take an old scarf, fold up one end to the size of your container and sew the edges. I have also seen crocheted caddies with a string that goes around your neck!



[Image description: Three images in one. Top left is a purple scarf with a pouch sewn in and a bottle with feeding tube in the pouch. Bottom left is a specially made scarf holding a SNS device. Right hand picture is a turquoise crocheted bag with a cord to wear around the neck]



There are other feeding devices available if an SNS doesn't work for you, please reach out to us for more information.