Finger Feeding (best learned by watching and doing)
Wash your hands. It is better if the finger nail 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. Any position which is comfortable, however, 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. Generally, the baby will begin
to suckle even if asleep, and receiving liquids will then 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. 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 full or 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. Try to keep your finger straight, flattening the baby's
tongue. Try not to point your finger up, but keep it flat, thus keeping down the baby's
tongue, and working the lower jaw forward.
The use of finger feeding with a syringe to push milk into the baby's mouth, is, in my
opinion, too difficult and definitely not more effective than simply using a bottle
with the nipple hole enlarged and the tube coming from it.
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 of 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.
by Jack Newman, MD, FRCPC
