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Report # RPT021
A
Comparative Survey of Experiences with Nursing Supplementer
Systems, 1985 to 1996.
by Jimmie Lynne Avery

Abstract: A survey from 1985 to 1996 has been collecting and
examining experiences of women who used and compared different
types of breastfeeding supplementer systems. Data was collected
from written reports submitted by the subjects who participated
in the survey. Representative comments are presented to provide
an overview of the types of experiences that were reported
comparing results with Lact-Aid® Nursing TrainerTM System,
after initially using an alternative supplementer system. The
purpose of the survey was to determine what features related to
product effectiveness and safety were observed and/or considered
important, or desirable, among users familiar with at least two
alternative devices. Data obtained was then reviewed to develop
educational material in response to questions asked by nursing
mothers and health care practitioners contemplating use of
breastfeeding supplementer systems.
Introduction:
Before 1969, efforts were often unsuccessful to facilitate
relactation or induced lactation, or to greatly increase
lactation when milk volume was very low. Then and now, all these
circumstances present certain requirements which absolutely must
be met. These include:
- First and foremost, the infant must be assured of
adequate nourishment.
- The mother must receive effective breast stimulation and
effective expression of available milk from the breast.
- In the absence of adequate milk volume, the infant must
be enticed or coaxed to accept, and suckle the breast.
- Methods used must be safe, not only to physical health
and well being of the breastfeeding dyad, but must not
harm the mother/infant bond, nor the overall family
relationship.
Nursing assistance devices available up to that time included
cups, medicine droppers, syringes with or without tubing
attached, gavage feeders, pointed bottles, such as used for hair
tint solution or food condiments (catsup, mustard bottles). None
fostered correct suckling physiology for the infant, and safety
continues to be highly questionable, with aspiration being the
major risk factor. .
It is said that imitation is the greatest form of flattery.
The Lact-Aid® NursingTrainerTM System was introduced in
Denver, Colorado, in 1971 following three years of careful
research and testing. It has often been imitated, by both
home-made gadgets and by commercial products. None have ever been
able to match the proved effectiveness associated with the
Lact-Aid® name.
In terms of milk production, for example, a 1978 study of 660
women who attempted relactation in various situations, yielded
highly positive results. Of 240 adoptive mothers, about
two-thirds estimated they were able to provide their babies 50 to
75 percent of their nutrition as breast milk, once lactation was
well established. This included about a third of the mothers who
had never been pregnant.
Other situations studied included mothers of premature
infants(117), mothers attempting to relactate after untimely
weaning(175), and mothers whose breastfeeding had been
interrupted by hospitalization of mother or baby(75). The results
of their experiences were even more positive
It is significant that at the time of the study, the Lact-Aid® System was the only commercially available
feeding tube system. It was the device used by most women in the
study. Other supplementing methods used included infant nursing
bottles, cups, medicine droppers, and dropper-type bottles. Since
that time, other devices have appeared (and disappeared) in the
nursing aid market. None have been able to demonstrate positive
results to the extent that has been associated with Lact-Aid® System. That is because no other nursing
supplementer (feeding tube device) functions exactly the same way
as the original invention.

Purpose of the survey
It was decided to conduct a two part survey to determine how
customers, and how health practitioners, particularly lactation
consultants, perceived similarities and differences between
various supplementer systems available. The data would be
compiled, in order to develop useful information for developing
or improving product information and instructions. Lact-Aid was
particularly interested to develop material in response to
increasing inquiries from prospective customers, and lactation
consultants about Lact-Aid® System and how
it differed from other alternative methods.

Methodology
The survey incorporated three separate processes for
collecting information:
- An ongoing survey of the literature on breastfeeding,
particularly in the subject areas of relactation, induced
lactation, adoptive nursing, slow infant weight gain,
prematurity, cleft lip/palate, and related subjects in
which a nursing supplementer system might be used.
- A review of correspondence received from health
professionals, which includes physicians, nurses,
midwives, certified and non-certified lactation
consultants, lactation educators, La Leche League
leaders, and leaders of parent support groups related to
breastfeeding, adoption, premature infants, cleft
lip/palate, and related subjects.
- Customers who purchased a Lact-Aid System after initially
using an alternative supplementer were provided survey
forms to complete. They were asked to describe in their
own words why they preferred Lact-Aid System over
alternative supplementer systems.
With the development of online media, the ongoing survey has
been expanded to include these additional components:
- Ongoing review of online bulletin boards/newsgroups for
discussions or posted messages regarding use of nursing
supplementer systems.
- Ongoing review of online texts presented as educational
information on web pages.
Data from online references will be added to this report soon.

Updates
The original report on this survey has been
revised and updated from time to time. In developing the material
and adapting it for online publication, Lact-Aid will be making
regular updates. These will be announced in News and
Announcements, and will be annoted in this report as well. We
welcome your suggestions and recommendations for additional
resources to include in this ongoing survey.
May 08, 2008.
This report DRAFT created for online publication.
To be revised.

SURVEY RESULTS to Date
What health practitioners have said
The initial review of literature and professional
correspondence yielded numerous positive references to Lact-Aid
System. Most consumer oriented texts on breastfeeding published
since 1971 made positive statements about the effectiveness and
usefulness of Lact-Aid System. None of the comments were paid
advertising nor solicited by Lact-Aid. Likewise, in texts
directed to health professionals, authors have commended Lact-Aid
System for nearly a quarter of a century for its proved safety
and effectiveness in managing breastfeeding problems.
A detailed Bibliography will soon be added to
our web citing printed and online references to breastfeeding
and related subjects and to experiences with
Lact-Aid System. Watch What's New for announcements when
it becomes available. In the meantime, here are just a few
excerpts from letters received from health professionals, or from
publications on maternal and infant health:
| "Lact-Aid® System is
useful in relactation and in building up a milk supply
that has been diminished for whatever reason. All health
personnel should become familiar with (it).if they are to
effectively counsel lactating women." |
Victor LaCerva MD: Breastfeeding, a Manual for
Health Professionals.. |
| "While Lact-Aid® System
has been on the market since 1971 and has been proven
safe and effective, several other companies have since
developed similar devices that use a bottle or other
container, with varying degrees of safety and
effectiveness." |
M. S. Eiger & S. W. Olds: The Complete Book
of Breastfeeding. Rev. Ed. 1987 |
| "It assists a variety of breastfeeding problems,
including suckling defects ...This device provides the
correct rate of flow and volume of liquid that elicits
the reflexes of swallowing and expression ...(thus)...
provides oral therapy and nutritional supplement for the
infant and mammary therapy that enhances mother's
lactation...It is effective in managing low milk
production in the mother caused by separation, delayed
breastfeeding, poor technique, or other correctable
problems and giving nutritional and oral therapy to the
infant who is slow gaining or has a suckling
dysfunction." |
L.E. Weisman, & J. L. Collins:
"Breastfeeding the Sick Neonate", in G.B.
Merenstein, & S. L. Gardner, Eds: Handbook of
Neonatal Intensive Care. Chap. 10.
|
| "The Lact-Aid® System is
becoming known as a tool that can take the place of
bottled supplements. The amazing way it helped was
something I'll be eternally grateful for. The success the
mother had with it helped to rebuild her confidence as a
mother. There are no words to describe the good you do
with this product." |
Lactation Consultant |
| "We found Lact-Aid®
System works very well as a follow up to the breast
pump." |
Lactation Consultant |
| "...an excellent way to establish breastfeeding
without the worry of malnutrition, dehydration, or
choking is with a Lact-Aid® System
...Many mothers of preemies, as well as adoptive mothers,
have used it successfully to relactate or to induce
lactation." |
H. Harrison: The Premature Baby Book.
|
| "I am a La Leche League Leader and seem to often
be in contact with people needing help nursing an adopted
or cleft lip/palate baby. Our joint cooperation reveals
that Lact-Aid® System is
superior... Please continue your good work." |
D.M.M. La Leche League Leader
|
| "...the risks of starving a premature infant
while he adapts to the breast are real. The solution...is
to provide nourishment while the infant stimulates
maternal milk production by suckling at the breast. The
Lact-Aid® System will provide this
set-up very effectively...Experience to date...has been
good. The infant can continue to gain weight while
stimulating the breast. (It) provides a simple means of
assuring adequate nourishment while adapting to the
breast." |
R.A. Lawrence: "Breastfeeding the Infant With a
Problem", in Breastfeeding, a Guide for the
Medical Profession. 1985. |
| "None of the mothers in our group who used the
S__ have been able to get off it." |
J.S. |
| "We've had problems with the S__. We prefer to
recommend Lact-Aid System. It's been around a long time
and proved itself." |
Midwife |
| "One of the most pleasant and successful ways of
teaching a baby to nurse is through use of the Lact-Aid® System. Its specialized design and
function are based on knowledge of the process of
lactation, infant nursing behavior, and the factors
affecting breastfeeding success." |
D. Stewart & C. Gaiser: "Supporting
Lactation When Mothers and Infants are Separated", Nursing
Clinics of North America. Volume 13 (1). |
| "Had complaints that mothers can't tell the
sizes apart...of the tubing on the S__." |
K.C. |
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Experiences of mothers who switched to Lact-Aid® System
Apparently due to the high recognition of the Lact-Aid® name, some sales people and health
practitioners have called the alternative devices they dispense
by the term "Lact-Aids", which is improper use of the
Lact-Aid® trade mark. Dissatisfied with
their experience, many of their clients called information to
find a number for "Lact-Aid" and were referred to
Lact-Aid International, Inc. headquarters. It was only when they
called the Lact-Aid® Hotline to complain
about problems they were having, that they discovered their so
called "Lact-Aids" were not Lact-Aid®
brand nursing supplementer systems. After being informed about
the differences in the devices, most decided to switch to
Lact-Aid System. In order to learn how the customers perceived
their experience with both systems, Lact-Aid immediately set up
the ongoing survey and established a unique Trade-In Offer.
Ask about it.

What the mothers experienced
While many experiences have been collected, several themes
have appeared again and again in their commentaries. Some
representative remarks are presented which are typical of
experiences described by women who started out using an alternate
nursing supplementer device, and then switched to the Lact-Aid® NursingTrainer
System.
Prior to switching, they commonly reported making
little or no progress in increasing their lactation, and they
continued to experience menstruation. Many reported that they
could express or pump milk after feedings, which they believed
indicated that Baby had failed to express the breasts adequately
during the supplemented feedings. Many reported nipple discomfort
from Baby's strong suction during the feedings.
After switching to Lact-Aid®
System, they reported that Baby's suction was more gentle, but
swallowing was more frequent. Baby seemed to express the breasts
more effectively. This was assumed because less milk was left in
the breasts after feedings. Lactation increased, indicated by
decreases in supplement used, wetter diapers, and softer stools.
The menstrual flow also decreased or was skipped entirely, which
is typical of normal postpartum lactation amenhorhea.

What the mothers said...
With such dramatic changes that occurred, it is no wonder that
the mothers had a lot to say about their experiences. Here, in
their own words are just a few comments, typical of the many
survey forms received.
| I tried another supplemental device, and there is no
comparison. This is only my second day using Lact-Aid® System and our adopted son is eating
better now than 12 days of S__. I got frustrated with
that hard plastic bottle. To keep him sucking I had to
hold pressure on the bottle. I even tried the larger tube
on the S__. But he'd slurp it down and still not be
satisfied. I nursed 5 daughters and the S__ is so
artificial, hard. I was real discouraged with the whole
experience. I thought the S__ the lactation group leader
sold me was Lact-Aid® System ..She
never said it wasn't. Using Lact-Aid®
System feels more natural and I am more relaxed and doing
better now. I plan to let others know about it. E.P |
| Like no other system I've used, it teaches Baby
proper suckling. The tube is softer and more gentle for
baby to suck without the use of tape. It's discreet and
simple to use anywhere The S__ cuts into the flesh, flows
unevenly, clogs easily, has stiff tubes that tend to gag
baby and requires tape to hold the tubes in place. I
nursed babies born to me as well as a recently adopted
infant. I know first hand what suction, let down, and
fullness of the breasts should feel like. With Lact-Aid® System has come increased milk
production for me as well as proper suction, greater let
downs and frequent breast fullness. It helps decrease
sore nipples. The S__ just feeds the baby instead of
teaching the actual art of breastfeeding. I'm very
pleased with the bags, they're sturdy as well as soft,
don't leak and can stand a lot of pressure,. Nursing is
more frequent. The amount of formula has decreased and
the bond between Baby and me has become stronger. Quite
frankly, I was getting so tired of the S__ for so many
reasons, I was nursing only once a day or every other
day. By the way, my adopted baby had to be trained to
nurse. Weeks passed and no matter how hard I tried with
the S__ she just refused. When I tried Lact-Aid® System the first time, to my
amazement, my baby latched right on. Thank you for such a
great invention for mothers like me interested in
nurturing their children like God intended. C.S. |
| When I used the S__, breastfeeding was a chore - tube
fussing - neck cord choking - My nipples were sore. I
wasn't sure how long I'd put up with it. Now, having
switched, I love our nursing times together. I disliked
the S__ for several reasons: the plastic bottle was
cumbersome, bulky hard bulge in the middle of my chest,
unsightly and uncomfortable I questioned its cleanliness.
I disliked applying tape to my breast and looking like a
hospital case with IVs taped on me. Lact-Aid® System Bags are soft to the touch,
sterile. The Nursing Tube is easy to handle. I can
discretely nurse without a bulge on my chest. I feel more
feminine, and natural. I love the flexibility of how I
can attach it, your comfortable neck cord, pretty eyelet
pocket. I'm lactating and owe our success to Lact-Aid® System. S.J.W. |
| I was not comfortable using the hard, rather large
bottle of the S__. It was not discreet because of its
size. It made a terrible noise all the time when air was
leaving the unit, which often startled, and upset Baby.
The 2 tubes were unnecessary and would leak on the side
not in use. If closed off, it would be very difficult for
Baby to suck the milk out. After 2 weeks, my milk began
drying up! I began using Lact-Aid® System
and my milk began to increase. For me, personally the
Lact-Aid System is as close as you can get to
breastfeeding. I can nurse Baby in almost any position,
in bed lying down was no trouble at all. J.J. |
| It is a much more convenient system because of the
discreteness; much easier to use in public (as opposed to
having a plastic bottle hanging around your neck). I
think the Lact-Aid System feels more natural too. B.B. |
| The Baby nurses better. It feels much more
comfortable to wear around my neck. Much nicer than a
hard plastic container. B. K. |
| I had used another system and was not pleased with
what I got. The bottle would hang around your neck upside
down and leak. It also hit my chest when I moved. It made
it hard to nurse privately around people. I always had so
much explaining to do. D. L. A. |
| I am happy about being able to fill and store nursing
bags in advance. No more strange bulges under my shirts.
L.T. |
| Baby expresses better and I get more stimulation to
my breasts. With Lact-Aid® System
my breasts empty completely of breast milk. Pumping after
feeding is rarely needed. No need to use tape. Baby is
able to control milk flow on his own. With the S__, milk
flowed whether Baby sucked or not, if both tubes were
open, Baby would often choke. J.C.R. |
| I feel my baby is now suckling properly and taking a
more regulated flow of milk as he nurses. I did not like
the air my baby was taking in because of the bottle-type
system. K.W. |
| My first week breastfeeding was a disaster with a
S__. Even a $60 consultation with a lactation consultant
failed to solve the problems I had using it. With
Lact-Aid® System our breastfeeding
is now very successful. My baby is gaining beautifully.
J. A. M. |
| Your system is best for my needs. It's the most
discreet..also the quietest! The other had a hard plastic
container that gurgles constantly. I found that most
annoying. Lact-Aid® System fits my
busy, on-the-go life quite well. It allows discreet
nursing with a minimum of bulky apparatus. M.H. |
| I was very disappointed with the other system. I was
wearing this ugly bottle around my neck, upside down and
it leaked. The tubes were so long, I had to use tape. The
more tubing the more chance for Baby to grab. The bottles
began to get a build-up in them and looked dirty despite
cleaning and boiling. But now, with your pretty holder, I
can just pick up my Baby, pop my Lact-Aid®
System in the holder on the way to my rocker, sit down
and nurse! C.M. |
| With the other device, The neck strap broke, the
cleaning syringe broke, a piece of tubing broke off and
tubing became coated with glue from the tape even with
diligent cleaning. The Lact-Aid®
System tubing is thinner and much easier to manipulate
Bags are so much softer and less bulky, and also less
conspicuous. It feels very natural. The most important
reason is Baby nurses without difficulty. N.G. |
| The other kind did not provide supplement with each
suck, and it seemed to take milk out of Baby's mouth and
draw it back up into the tube when he rested. There seems
to be less fluctuation in flow rate and Baby doesn't gag
or choke as he did with the other if both tubes were
open. C.J. |
| With my last baby I ended up in frustration trying to
regulate the flow of the other device. I switched back to
the Lact-Aid® System , a much
superior nursing aid that I had used with my first two,
due to breast surgery. P.S. |
| We love Lact-Aid® System ! The
disposable bag is less obtrusive under clothing and
allows closer cuddling than a rigid bottle. K.W. |
| I don't have to wash and sterilize the
bags. I think one tube to deal with is a lot less hassle.
Lact-Aid System is much less bulky during use and makes
nursing in my special situation more discreet. C.M. |
Considering these positive experiences of women who used other
devices then switched to Lact-Aid® System,
the fact remains clear that no other method equals Lact-Aid® Nursing Trainer
System.

The Secret of Lact-Aid®
Excellence
With Lact-Aid® System, Babies typically
swallowed more often, and expressed more often than they did with
the alternative devices their mothers had used at first. Their
mothers experienced positive changes in lactation and menstrual
patterns. All these factors validate the fact that switching to
Lact-Aid® System was an excellent choice,
but do you know why?
Nutritive
suckling
at its best
|
|
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The secret is the fact that expressing is the
component of suckling that has the most importance in eliciting
milk ejection and stimulating lactation. During normal nutritive
suckling in breastfeeding, studies show that babies express the
breast about 60 times a minute (with little pauses now and then).
Suction (negative pressure) is strong during latching on, but
quite gentle during nutritive suckling, and swallowing is
frequent. Just like Lact-Aid® System!
We are very proud that our Lact-Aid® NursingTrainer
System was so carefully bio/medically engineered. It has proved
effective as an oral physical therapy for babies with suckling
problems, including cleft lip/palate!
Its unique design focuses on promoting the highly effective
kind of expressing that is characteristic of nutritive suckling.
Other devices appear to be designed with their focus on suction.
Lact-Aid® ,
our signature of excellence and our registered trademark
- Lact-Aid® is our registered
trademark and not a generic description for nursing
supplementers or feeding tube devices. It is our
signature of excellence, to show we stand behind the
quality and performance of our product.
- If you are a health practitioner such as a doctor, nurse,
lactation consultant, midwife, parent support group
leader, and you want to recommend or prescribe our
product, this is what you can do to be sure your clients
get the right equipment:
- Use the right brand name. Ask for Real Lact-Aid® Brand Nursing Trainer System.
- Describe it. Real Lact-Aid® System
is the one with the nursing bags. If it has something
else, its not Lact-Aid® brand.
- Never call other items a Lact-Aid®.
Unless the package and printed instructions say Lact-Aid®, they aren't. If people call other
items Lact-Aid® in order to sell
them, it's against the law.
- Report problems in getting Real Lact-Aid®
Brand. If you ask for it, but end up getting something
else, let us know and we'll see that you get the right
product.
- Don't get mad if you hear about problems someone has with
a Lact-Aid® . Find out first if it
is the Real Lact-Aid® Brand
Nursing Trainer System
being used. Then contact
us. If it isn't, have the person contact us for an
opportunity to experience the REAL ONE and learn about
our Trade In Offer! If it is ours, we
want to know so we can help resolve any genuine problems.

Trade-In Offer: Are you or your breastfeeding
clients dissatisfied with an alternate nursing supplementer
device? Consider switching to Lact-Aid®
System. For details on our special Trade-In Offer, just write or
give us a call or E-Mail
us.
Lact-Aid Publications: Results of the
Relactation Study are available as Monographs by K. Auerbach
& J.L. Avery. For our complete catalog listing these and
other related topics, ask for Form P003 or see our online
publications catalog Lact-Aid Library.
Referrals to Suppliers & LAMBs: Call or
write or E-Mail us for a referral to a supplier near you. Also
ask about our growing network of volunteers, LAMBS Lact-Aid® Moms' Buddies, who offer TLC and mom-to-mom
support. Let us know if you are interested in becoming a supplier
or a LAMB.

REFERENCES
Auerbach KG & Avery JL: Nursing the Adopted Infant:
report from a survey. Monograph No. 5. Denver, 1979,
Resources in Human Nurturing, International, Inc. (Now available
as Monograph # M005, from Lact-Aid International, Inc.
Avery JL: Relactation and induced lactation, Chapter
13, in Riordan J: A Practical Guide to Breastfeeding. St.
Louis, 1984, CV Mosby Co.
Avery JL: Unpublished Data from Lact-Aid International,
Inc. client files, 1969 to 1984.
Avery JL, Ed: Unpublished Data from Lact-Aid
International, Inc. client files, 1985 to 1998.
Hormann E: Breastfeeding the adopted baby, in Birth
& the Family Journal. Volume 4:p165, 1977.
McGregor JA: Lactation: Physiology, Nutrition, and
Breast-Feeding. New York, 1983, Plenum Press.

NOTE: This report is adapted from a summary brochure
entitled Lact-Aid Excellence, ©Copyright 1995, 1996,
& 1998 by Lact-Aid International, Inc, plus updated
unpublished data to date from Lact-Aid client files. All rights
are reserved. This publication may not be modified nor altered in
any way, nor reproduced in whole, nor any part, by any means,
photographic, electronic or otherwise, without the express
permission of the author, except for free distribution for
educational purposes only.
Disclaimer:
The information presented here is for educational purposes only,
and is not intended to provide or substitute for medical advice
in any way.
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For information on other Lact-Aid Reports,
Publications, and Services, or for more details about Lact-Aid®
Nursing Trainer System, please contact us at:
LACT-AID INTERNATIONAL, INC.
Phone (423) 744-9090
Fax (423) 744-9116
Email info@lact-Aid.com
Mail P.O. Box 1066
Athens, Tennessee 37371-1066
USA

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International, Inc. All rights reserved.
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