A lactation aid is a device that allows the baby to be supplemented with expressed breastmilk, formula, physiological water (only in the first 2 or 3 days) instead of using a bottle. The lactation aid, we would suggest, is better than using a syringe, cup feeding, finger feeding or any other method, since the baby is on the breast and breastfeeding instead of away from the breast during supplemental feeding. See also our blog on Using a Lactation Aid for photos and a video clip on its use.
A note about bottles: The use of bottles with a baby of any age may result in the baby becoming fussy at the breast or even refusing to latch on to the breast. This is because bottles provide fast and consistent flow that the baby may begin to prefer over the flow of the breast which is often variable in quantity and flow rate. Bottles also teach babies a different latch and suck that can result in slower flow from the breast and the baby receiving more and more from the bottle.
Though bottles do not always cause problems as above, their use when there are already breastfeeding challenges will rarely make things better and usually makes things worse.
And newer bottle nipples are no better than the old ones; to suggest that is just good marketing!
A lactation aid consists of a container for the supplement—usually a feeding bottle with the nipple hole cut to be larger—and a long, thin tube leading from this container. A medical feeding tube that is 91 cm (36 inches) long with a diameter of “5 French” works best. Do not cut off the end of the tube as cutting it makes the end sharp which may injure the inside of the baby’s mouth.
Manufactured lactation aids are available and may be easier to use in some situations, but not necessarily. In fact, we believe our “homemade” lactation aid is usually easier to use and much less expensive to buy.
Please Note: Using a tube with a syringe, with or without a plunger, instead of the setup mentioned above, offers no advantage and is usually more difficult to use. It does not either make the lactation aid any better somehow. Also, with a syringe, there is a temptation to push the milk into the baby’s mouth. Using it this way does not teach the baby how to breastfeed because s/he gets milk regardless of how the baby sucks.
Use of the lactation aid should be shown by a person experienced in helping with breastfeeding.
Ensure the baby is well latched on. See the “Latching and Feeding Management” information sheet as well as our blog What is a good latch and latch quiz. Note that a baby with a tongue tie does not have a good latch.
Generally, the tube should be added after the baby has breastfed on both breasts and the flow has slowed down on the second breast (baby is mostly sucking with few drinks), but your Lactation Consultant may recommend something different depending on your situation.
See this video shows a baby drinking at the breast using the lactation aid. If the tube were better placed, the baby would drink even better. How do you know the baby drinks at the breast? See these videos 1. really good drinking. The pause in the chin tells you the baby is drinking 2. Almost no drinking. No pauses in the chin 3. Borderline drinking even after adjusting the latch, and using breast compressions.
If the baby is well latched on, the baby will have an asymmetric latch which will allow the tube of the breast to be easily slipped along the breast and into the baby’s mouth. See this video. Gently ease the breast away so the corner of the baby’s mouth is easily seen. However, if you watch the video again you will notice that if the baby is well latched on, there is no need to move the breast out of the way.
Hold the tube close to the end with your index finger and thumb. Bit by bit, slide the tube under the baby’s top lip (anywhere between the middle of the top lip and the corner of the mouth). The tube should slide into baby’s mouth alongside the nipple – push the tube away from the breast and aim it toward the roof of baby’s mouth..
Hold the tube alongside the nipple, with the tip of the tube just slightly past the tip of the nipple. Latch the baby onto the breast and the tube all at once.
The lactation aid is well placed when the supplement works its way down the tube quickly as the baby sucks. There is usually no need to fill the tube with supplement before putting it into the baby’s mouth. Use the lactation whenever necessary to keep the baby drinking. Better eight supplements a day of 30 ml (1 ounce) per feeding than 2 large supplements a day of 120 ml (4 ounces) each, for example.
Allow the baby to drink as much supplement as he or she wants. The baby will stop eating when he/she is full – the baby cannot be overfed when getting the supplement by lactation aid at the breast
7. It should not take a long time for the baby to drink the supplement. If it is taking a long time, the tube is probably not well positioned, the baby is poorly latched on, or both. When the lactation aid is functioning well, it takes 15-20 minutes, usually less, for the baby to take 30 ml (1 ounce) of the supplement.
1, Use a syringe to flush out the tube with hot water (soapy water may be used if desired but be sure to rinse the tube well with hot water).Use the empty syringe to push some air through the tube to help it dry. Hang the tube to finish drying.
2. Do not boil the tube of the non-manufactured aid. It is not made to be boiled.
3. Clean the bottle as usual.
4. The end of the tube that goes into the baby’s mouth will get stiff with use. You will notice this after a few days to about a week, depending on how often you use the tube. When the tube is stiff, replace it. Do not cut the end of the tube off.
Generally, the baby will begin to take less and less supplement as the breastfeeding improves and/or the breastmilk supply increases.
It is best to allow the baby to decide when the supplement is no longer needed, rather than decreasing how much or how often supplement is offered.
Watch the baby at the breast. If you can keep the baby drinking well using breast compressions and switching sides, then you likely do not need the lactation aid at that feeding. If in doubt, add the tube after feeding on at least both breasts – if the baby is full he/she will not take much (or anything) from the supplement container.
The lactation aid may be required for just a few days to several weeks. Usually, the amount of supplement required in the lactation aid increases over the first one or two weeks of use, and then levels out for a variable period of time before decreasing. The whole process may take two to eight weeks or longer, although some mothers have used the device only a few days, whereas others have not been able to stop using it at all until the baby was well established on solids.
Do not be discouraged and do not try to force the weaning. Rapid improvement sometimes occurs after a long period of little change.
If the lactation aid is still being used when the baby is ready for solid foods, the baby can be transition from taking supplement at the breast to eating food, with or without the supplement mixed into it. See the “Starting Solid Foods” information sheet and this blog on food.
When is the baby ready for food? If your baby still depends on the lactation aid with formula when the baby turns 4 months (or so), instead of formula, give the baby food. As much as the baby will take, as often as the baby will take the food, without forcing. You can add your milk or other liquids such vegetable oil to the food. The baby doesn’t have to drink any supplement. Don’t give commercial infant cereals which are expensive, low in nutrients, bad tasting and often constipating. You may not be able to stop the bottles immediately, but it may take a week or two. Click this link http://ibconline.ca/food/ for information on starting food. The baby will be breastfeeding and eating food.
The information presented here is general and not a substitute for personalized treatment from an International Board Certified Lactation Consultant (IBCLC) or other qualified medical professionals.
This information sheet may be copied and distributed without further permission on the condition that it is not used in any context that violates the WHO International Code on the Marketing of Breastmilk Substitutes (1981) and subsequent World Health Assembly resolutions. If you don’t know what this means, please email us to ask!
©IBC, updated November 2016, 2021
Questions or concerns? Email Dr. Jack Newman (read the page carefully, and answer the listed questions).