Alternative Feeding Methods

Sometimes babies may need a substitute feeding method to get the nutrients they need to stay healthy. It is important that you use methods that will not result in the refusal of traditional breastfeeding when they are ready.

Assisted Feeding at the Breast/Chest 

(Often referred to as a supplemental nurser system (SNS))

Tools to Help

• Feeding tube and/or syringe
• Pumped breastmilk, donor milk or breastmilk substitute

How to Feed Your Baby

• Place the baby at breast/chest in cradle or football hold
• Help the baby to latch
• Slip the feeding tube and/or syringe into the corner of baby’s mouth OR you can tape the tubing to the breast so the baby latches to both the breast and the tubing
• Reward sucking with a small drop of milk
• Observe for swallowing and signs of too fast or slow milk flow

Cup or Spoon Feeding

Tools to Help

• Small cup (medicine cup, shot glass, etc.)
• Teaspoon
• Pumped breastmilk, donor milk or breastmilk substitute

How to Feed Your Baby

1. Fill cup not more than 3/4 full
2. Make sure the baby is in a position that they cannot accidentally hit the cup/spoon
3. Tip cup so fluid level is at the tip and place cup onto baby’s lip
4. Allow baby to lap or sip milk
5. Leave the cup in place, only removing to refill it
6. Let baby feed at their own pace
7. Observe for swallowing and signs of too fast or slow milk flow
8. DO NOT POUR MILK INTO BABY’S MOUTH
9. Stop to burp from time to time
10. Do not use this method if your baby is not alert, sleepy or ill

Finger Feeding

Tools to Help

• Feeding tube, curved tip or 5-20 cc syringe
• Pumped breastmilk, donor milk or breastmilk substitute

How to Feed Your Baby

1. Wash your hands
2. Fill small container with milk
3. Insert your finger (tip up) slowly into baby’s mouth
4. Slip the feeding tube or syringe into the corner of baby’s mouth or have it taped to your finger
5. The baby will pull the milk from the container as they suck on your finger
6. The baby should always be in control of the flow
7. Observe for swallowing and signs of too fast or slow
   milk flow

Paced Bottle Feeding

Tools to Help

• Nipple with medium/wide base and a slow flow (baby’s mouth should be able to open similar to breastfeeding)
• Pumped breastmilk, donor milk, or breastmilk substitute

How to Feed Your Baby

1. Position baby nearly upright in your arms
2. Simulate attachment to the breast by resting the nipple on the
   middle of baby’s upper lip
3. When baby’s mouth opens, tip the nipple deeply into the mouth
4. Position the bottle horizontally to aid in pacing the feed
   (lower the bottle quickly if the milk is flowing too fast for the
   baby to swallow)
5. Pace the feeding to the same suck-swallow-breathe and
   pause pattern as when breastfeeding
6. Observe for a good latch on the bottle, including:
   1. The nipple reaching deeply into the mouth
   2. The tongue cupping the nipple
   3. The lips open widely and resting on a portion of the base
   4. The lips forming a complete seal, with no leaking at the corners
   5. The baby comfortable with the flow (not falling asleep or gulping)
7. Feeding session should last as long as breastfeeding (roughly 10-20 minutes) and may be offered intermittently with direct breastfeeding