Another way to adjust the flow is by the height of the
device. When the bottom of the SNS bottle is above the
level of the nipple, the supplement will flow more quickly
and will continue to flow into the baby's mouth even when
sucking has topped. Such a non-stop flow can be uncom-
fortable so use extreme caution when the device is above
the level of your nipple, especially if the baby seems to
loudly gulp or choke. (Most babies will stop and pull away
if this should happen.)
Similarly, when the SNS is placed below the level of the
nipple, the baby must suck against the flow of gravity. It
could be difficult for the baby to suck the supplement in
this case. If your health care professional suggests the
technique, make sure the baby swallows with every suck
or every other suck.
The flow can also be increased by squeezing the bottle
in some cases. Place the heel of the hand against bottle
while supporting the breast and gently compress the SNS
to force more supplement through the device. This could
be used when the infant has a very weak suck or needs
that extra assistance, such as with the reluctant nurser.
Some mothers have found that warming the supplement
in the SNS will increase the flow. It is usually not neces-
sary to do this. However, it is an additional way to
increase flow.
The versatility of the Medela SNS allows you to vary the
rate of flow: To summarize
Increase Flow
1. Use larger tubing
2. Raise device
3. Squeeze bottle
4. Lengthen tube
5. Warm supplement
Decrease flow
1. Smaller size tubing
2. Lower device
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