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Finger Feeding
Handout #8. Finger Feeding. Revised January
2005
Written by Jack Newman, MD, FRCPC. © 2005
Introduction
Finger feeding is a method that helps train the
baby to take the breast. It can also be used to avoid artificial
nipples, but its primary purpose is to help latch on
a baby who refuses to latch on. (See handout #26 When
a Baby Refuses to Latch On). If you want to breastfeed
successfully, it is better to avoid the use of artificial nipples
before your milk supply is well established. Finger feeding may
be used if:
-
The baby refuses
the breast for whatever reason, or if the baby is too sleepy
at the breast to nurse well. It is also a very good way
to wake up a sleepy baby during the first few days of life.
- The baby does not seem to be able to latch
on to the breast properly, and thus does not get milk well.
(However, if a lactation
aid can be used at the breast, why use finger feeding?).
-
The baby is separated from the mother, for whatever
reason. However, in such a situation, a cup is probably a better
method of feeding the baby.
-
-
Your nipples are so sore that you cannot put
the baby to the breast. Finger feeding for several days may
allow your nipples to heal without causing more problems by
getting the baby used to an artificial nipple. Cup feeding is
also more appropriate in this situation and takes less time.
This is only a last resort. Proper positioning and a
good latch
help sore nipples far more frequently than finger feeding (Handout
#3
Sore
Nipples). And a good
all
purpose nipple ointment will help more. This so called “nipple
holiday” is usually a mistake and if suggested within
the first few days of life is a terrible mistake. Taking the
baby off the breast does not always result in painless feedings
once you start again, and sometimes the baby will refuse to
latch on.
Finger feeding is much more similar to breastfeeding
than is bottle feeding. In order to finger feed, the baby must
keep his tongue down and forward over the gums, the mouth wide
open (the larger the finger used, the better),
and the jaw forward. Furthermore, the motion of the tongue and
jaw is similar to what the baby does while feeding at the breast.
Finger feeding is best used to prepare the baby who is refusing
to latch on to take the breast. It should be used for a minute
or two, at the most, just before trying the baby on the breast
if the baby is refusing to latch on. Cup feeding
is usually easier and faster when the mother is not present to
feed the baby and is better to finish the feeding, if finger feeding
is slow.
Please Note: If the baby is taking
the breast, it is better by far to use the lactation
aid tube at the breast, if supplementation is
truly necessary (See handout B: Protocol
to Increase Breastmilk Intake by the Baby, and handout
#5, Using
a Lactation Aid). What sense does it make to finger feed
after breastfeeding?
Finger Feeding (best learned by watching and doing)
-
Wash your hands. It is better if the fingernail
on the finger you will use has been cut short, but this is not
necessary.
- It is best to position yourself and the baby comfortably. The
baby's head should be supported with one hand behind his shoulders
and neck; the baby should be on your lap, half seated, and facing
you. However, any position which is comfortable for you
and the baby and which allows you to keep your finger flat
in the baby’s mouth will do.
-
You will need a lactation aid, made up of a
feeding tube (#5F, 36" long), and a feeding bottle with
expressed breast milk, sugar water, or if necessary, formula,
depending on the circumstances. The feeding tube is passed through
the enlarged nipple hole into the fluid.
-
Line up the tube so that it sits on the soft
part of your index (or other) finger. The end of the tube should
line up no further than the end of your finger. It
is easiest to grip the tube, about where it makes a gentle curve,
between your thumb and middle finger and then position your
index finger under the tube. If this is done properly, there
is no need to tape the tube to your finger.
-
Using the finger with the tube, tickle the
baby's lips lightly until the baby opens up his mouth enough
to allow your finger to enter. If the baby is very sleepy, but
needs to be fed, the finger may be gently insinuated
into his mouth. Pull the baby’s lower lip out if necessary.
Generally, the baby will begin to suckle even if asleep, and
receiving liquids will then usually awaken him.
-
Insert your finger with the tube so that the
soft part of your finger remains upwards. Keep your finger as
flat as possible, thus keeping the baby’s tongue flat
and forward. Usually the baby will begin sucking on the finger,
and allow the finger to enter quite far. The baby will not usually
gag on your finger even if it is in his mouth quite far, unless
the baby is not hungry or he is very used to bottles.
-
Pull down the baby's chin, if his lower lip
is sucked in.
-
The technique is working if the baby is drinking.
If feeding is very slow, you may raise the bottle above the
baby's head, but usually this should not be necessary. Try to
keep your finger straight, flattening the baby's tongue. Try
not to point your finger up, but keep it flat.
-
The use of finger feeding with a syringe to
push milk into the baby's mouth is, in my opinion, too difficult
for the mother to do alone and definitely not more
effective than simply using a bottle with the nipple hole enlarged
and the tube coming from it. The idea of finger feeding is not
to feed the baby! The idea is to train the baby to suck properly,
so pushing milk into his mouth defeats the whole purpose of
finger feeding.
If you are having trouble getting the baby to latch
on to or to suckle at the breast, remember that a ravenous baby
can make the going very difficult. Take the edge off his hunger
by using the finger feeding technique for a minute or so. Once the
baby has settled a little, and sucks well on your finger (usually
only a minute or so), try offering the breast again. If you still
encounter difficulty, do not be discouraged. Go back to finger feeding
and try again later in the feed or next feeding. This technique
usually works. Sometimes several days,
or on occasion a week or more, of finger feeding are necessary,
however.
If you are leaving the hospital finger feeding the
baby, make an appointment with the clinic within a day or so of
discharge. The earlier the better.
Once the baby is taking the breast, he may
still require the lactation aid to supplement for a period of time.
Although the baby may take the breast, the latch can still be less
than ideal, and the suckle may still not be efficient enough to
ensure adequate intake.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
Go to www.thebirthden.com/Newman.html
for videos that show you breastfeeding techniques.
Handout #8. Finger Feeding. Revised January
2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further permission,
on
the condition that it is not used in any context in which
the WHO code on the marketing of breastmilk substitutes is violated
