weaning from the SNS-- anyone done it?

[Llyra]

I've been supplementing my smaller twin with the SNS since she was a week old, using what BM I can pump and some formula. She was low birth weight, born three weeks early and much smaller than her twin, and had a weak suck and lost too much weight-- almost 20% of her birth weight. It wasn't an easy decision to make, to supplement, but I'm glad we did it-- she was down to 4 1/2 pounds and badly jaundiced and it was getting scary.

Anyway, she's a month old now, gaining nicely and nursing well, and I'm ready to get her off the SNS. My supply is still not keeping up with her needs-- she's getting about 6 oz a day of formula. I've tried just cutting out the supplementer entirely, but she often won't latch without it-- I think she's gotten hooked on the faster flow and the instant gratification. Also, if I had a singleton, I'd just take the baby to bed and nurse round the clock for a few days, and my supply would catch up to demand, but with twins (who won't nurse simultaneously!!!!) and a two year old, I'm ALREADY nursing pretty much every minute of the day anyway. My other twin, BTW, is pretty much exclusively breastfed and doing very well, gaining very quickly. He only gets a tiny bit of EBM occasionally when both twins happen to be hungry at the same time-- like I said, they won't nurse at the same time yet.

Anyway, I was just wondering if anybody had any ideas. I'm gonna call my LC, of course, but it costs me $100 every time she comes out here to see me, and I can't bring this whole traveling circus in to see her, so I'd rather not have to make an appt with her.

Thanks in advance for any ideas or suggestions!

[prettypixels]

Just some ideas for you... first, weaning from supplements should be gradual, not cold turkey.
http://www.kellymom.com/bf/supply/decrease-formula.html
I think that applies whether you are using the SNS or a bottle or whatever.

Next you could try all kinds of things... I'd start with just using a little less supplement as recommended on the kellymom site. Maybe towards the end of some feedings slide the tube out *gently* so hopefully she won't notice, and let her keep nursing... after you've decreased the amount of supplement enough maybe try just leaving the SNS closed, or closing it at various points during the feeding so she is only getting breastmilk... only using the SNS at her *extra* hungry times of day, and just nursing when she is more relaxed and less hungry...

Those are really not in order, just off the top of my head and thinking while typing. I'm using an SNS too and I do believe babies can get addicted to them, just like they can get addicted to bottles! Nothing is like the breast, ultimately.

Would your LC at least answer q's on the phone? Both the LC's I've seen charge for in person visits but part of their care is answering questions on the phone. I never spent hours on the phone with them or anything, but they were available for a question like this, definitely! Anyways it can't hurt to ask!

[2 in August]

When I used a starter sns I found that where I had it determined the flow rate. So I didn't want ds to get used to a faster flow (we used it at the end of the feed to supp with formula). Anyway, what I did was to hold the sns just above his head to start and then move it lower. That made it like a giant straw that he really had to suck on it. Maybe after doing this for awhile she'll not like the sns so much and give it up.

[twinsarefun]

I am in the same boat as you and have twins. I urge you to get help from a highly qualified IBCLC only (not just LC). Make sure the consultant is familiar with pallate issues, tonque tie, etc... I wish I had this help in the beginning. I didn't know that my insurance would have paid for it before it was too late and my twins were hooked on the SNS. They were not gaining as yours, etc... I went to a LC when my babies were 6 wks and got bad advice. She wasn't a IBCLC (ilca.org for referral in your area) and got my babies hooked on the SNS. At 10 mo. I finally found a IBCLC who really knew her stuff. The babies had the bubble pallate and were not expressing the milk properly. If I had the right help in the beginning, I would have been told to suck train the babies and to not use the SNS. If I was to use the SNS, nurse first and then slip in the tube only afterwards for supplement. The first LC had me using a large tube (mistake) and the bottle held up very high (another mistake). This killed my supply. I eventually weaned the babies down to the smallest tube of the SNS and the container down to the lowest position. It takes time. Working down to the medium, then the smallest. Since your baby is so young, there is hope here when the prolactin levels are the highest and your milk supply is just getting established. I would pump with a hospital grade pump after each feed for about 10-15 min. This will tell your body to make more milk. Do you nurse your babies together on the EZ2Nurse pillow? That is a godsend to me. You can nurse both at the same time. I takes time to do that though in getting used to it. As your supply goes up, you can cut off the flow of the tube in the notch. The problem though, is the babies like the instant let down of milk that they get. I have read that to train the babies off of the SNS, first have them nurse without it. If they absolutely will not do it (like mine) and you are using the SNS, make sure they get nothing from the SNS for about a minute as they are nursing. That is about the time it takes for a regular mother's let-down. That will teach the baby that they cannot get an instant let-down. This will take time and patience. Especially with twins. I have two other children besides my twins, so I know what you are saying that it is hard with taking care of other children. I nursed two other children for three years, so this was really hard for me. Let me know how things go and if you need anything, feel free to send me a private message or write here. I wish you well. This is the optimal time to get off the SNS. The first LC said that my babies would self wean from the SNS by 12 wks. She was so wrong. By that time, they were so hooked and so much older and smarter, that we were really doomed with it. I don't want to see that happen to you. Take care!