What is a Supplemental Nursing System (SNS) and why are they used?

Also known as a supply line or lactaid.

When a baby can feed at the breast but is not able to fully meet their needs, supplemental expressed breastmilk, donor milk or infant formula might be added as a short or long-term strategy. A Supplemental Nursing System (SNS) is a way of doing so without separating feeding from the breast.

Some babies have a temporary or permanent barrier to effectively removing enough milk from the breast to fully satisfy their hunger. This can be due to pre-term birth, oral variations like tongue ties or clefts of lip or palate or injury during birth affecting the nerves associated with sucking.

For mothers whose breast development is atypical (Insufficient Glandular Tissue or IGT, for example), surgery or injury has damaged the breast or nipple function, or rare medical conditions prevent optimal lactation, fully meeting their babies needs with their own breastmilk might not be possible. However, breastfeeding is much more than breastmilk.

When known barriers to breastfeeding are identified before a baby is born, you can introduce an SNS right from the start however most people turn to them as part of a breastfeeding management plan for temporary imbalance in supply and demand. In this case, the removal of milk from the breast during a supplemented feed stimulates production and naturally boosts supply. Over time, the baby is weaned off the supplements and can be fully fed by the mothers breasts.

In the past, devices known as Supply Lines or Lactaids were made up using medical feeding tubes adapted for use with a basic baby bottle and these are still a simple and accessible way to go. Alternatively, commercial products like the Medela Supplemental Feeding System are an out-of-the box aid available from IBCLCs, pharmacies and even some baby stores.

Breastfeeding and Using a Supply Line fact Sheet - Royal Women’s Hospital

This video shows you how to make up your own supply line and also shows the option of finger feeding:

A leader in the use of supply lines is Dr Jack Newman. Jack is the founder and first pediatrician of the International Breastfeeding Centre. He has been helping breastfeeding mothers and babies for over 38 years. He has simplified the use of supply lines and has a technique of slipping the tube into the baby’s mouth whilst they are feeding, which many people find simpler than the traditional method of taping it in position before bringing the baby to the breast.

Using an SNS can feel overwhelming at first. Some health professionals may not have a lot of experience of supporting mothers using them and can seem unsupportive of their use. Being more familiar with using bottles for supplementary feeds, they might question why parents would choose this method instead. Remember though, your baby, your choice.