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What Is the Evidence for Use of a Supplemental Feeding Tube Device as an Alternative Supplemental Feeding Method for Breastfed Infants?

Penny, Frances, PhD, MPH, MSN, RN, IBCLC; Judge, Michelle, PhD; Brownell, Elizabeth, PhD; McGrath, Jacqueline, M., PhD, RN, FNAP, FAAN

Section Editor(s): Gephart, Sheila

doi: 10.1097/ANC.0000000000000446
Evidence-Based Practice Briefs

Background: According to the Healthy People 2020 goals, the sustainability of breastfeeding duration rates within the United States has not been achieved. To increase these rates, it is important that women with breastfeeding difficulties receive the support needed to continue breastfeeding. When supplementation occurs, it is essential that the breastfeeding relationship be preserved. Various methods of supplementation are often recommended including use of the supplemental feeding tube device (SFTD).

Purpose: The question guiding this brief is “What evidence exists to support the use of an SFTD as a method of supplementation for breastfed infants?”

Search Strategy: The PubMed and CINAHL databases were queried for original research published in English from 1990 through July 2016. Search terms included “supplemental feeding tube,” “breastfeeding,” “term infants,” “premature infants,” “Supplemental Nursing System,” “Lact-aid,” and “supply line.”

Findings: Very limited research exists on the use of SFTDs as a method of supplementation for breastfed infants; however, existing research suggests that an SFTD may be useful as a supplementation method for breastfed infants. High-quality research is needed to evaluate the efficacy of using an SFTD for supporting exclusive and all breastfeeding rates.

Implications for Practice: Nurses and providers need to be educated and trained in the use of SFTDs as well as all supplemental feeding methods. Information on efficacy and SFTD use should also be included in policies related to breastfeeding and human milk use.

Implications for Research: Further research should determine best methods of supplementation for breastfed infants and should examine differences in breastfeeding rates when using the SFTD for supplementation.

School of Nursing, Southern Connecticut State University, New Haven (Dr Penny); School of Nursing, University of Connecticut, Storrs (Drs Penny, Judge, and McGrath); Connecticut Children's Medical Center, Hartford (Drs Brownell); and School of Medicine, University of Connecticut, Farmington (Dr Brownell).

Correspondence: Frances Penny, PhD, MPH, MSN, RN, IBCLC, 12 Acorn Dr, Old Saybrook, CT 06475 (

Jacqueline M. McGrath, who is an Editor for Advances in Neonatal Care and a coauthor of this article, was not involved in the editorial review or decision to publish this article. The entire process from submission, referee assignment, and editorial decisions was handled by other members of the editorial team for the journal.

The authors declare no conflicts of interest.

© 2018 by The National Association of Neonatal Nurses