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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:
1. 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.
2. 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?).
3. 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.
4. Breastfeeding is stopped temporarily
(there are very few legitimate reasons to
stop breastfeeding. See handout #9a
and #9b,
You Should Continue Breastfeeding).
5. 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 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)
1. Wash your hands. It
is better if the fingernail on the finger
you will use has been cut short, but this
is not necessary.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. Pull down the baby's chin, if his lower
lip is sucked in.
8. 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.
9. 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? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
See
our 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
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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