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7.3 Finger Feeding

Finger feeding involves the infant sucking on the 'feeder's' finger with a source of supplement being given alongside the finger as the infant sucks well.

It is an alternative feeding method when an infant is unable to breastfeed.

It can also be used for modification of an inappropriate sucking technique.

In a NICU...

Finger feeding is an effective way to increase sucking abilities, accelerate the transition to breastfeeding, and shortens the duration of hospitalization in preterm infants.

The finger-feeding technique was shown to be a better feeding transition method regarding efficacy when compared with the cup feeding method, due to lower milk loss and fewer complication episodes.

Finger feeding can be considered as an alternative to cup feeding.

Finger feeding is easily taught to parents who can continue at home if necessary.

When to consider finger feeding

Finger feeding may be considered when:

  • the infant is unable to grasp the breast
  • the infant is refusing the breast
  • the infant is rousable but too sleepy for cup feeding
  • the mother/parent who has severely damaged nipples requiring an alternative feeding method during the healing process
    • this is helpful to the mother/parent and may also serve as a suck therapy for the infant during this time
  • as a 'pre-breastfeed' enticer for infants suffering from confusion or dysfunctional suck problems.

How to finger feed

Infant being finger fed human milk in an upright position

Infant being finger fed human milk in an upright position.
© J & B Eastgate

Equipment

  • Milk receptacle or Syringe and/or feeding tube
    • feeding tube with one end placed in a milk receptacle (cup, open bottle, or bottle with teat upside down) OR
    • regular or periodontal curved tip
  • Supplement (human milk, or if unavailable commercial infant formula)
  • Pillow or towel roll
  • Gloves (for all except the infant's own parents)

Preparation

Wash hands. Health professionals don gloves. (Parents need not use gloves)

Warm the supplement and pour into the milk receptacle or draw it up into the syringe. If a feeding line is being used - place it in the milk receptacle and tape distal end (tape is not always needed) to finger. If a syringe is being used attach the tube (be very careful with using a syringe).

NEVER force the milk into the infant's mouth, allow the infant to suck in the milk, and explain this to the parents

Support the infant on a pillow or on the lap of the feeder person.

Utilize the same positioning principles as used when feeding at the breast:

  • Infant well supported down the back
  • Infant's body in alignment with his head; neck slightly extended

Technique

  • The feeder uses their finger with the nail-side down and the soft pad of the finger to the palate.
  • The feeder's finger begins curled. Use the knuckle to gently stimulate the top lip and encourage tongue protrusion and gape.
  • Uncurl the finger under the top lip and introduce it along the palate.
  • Keep finger directly down midline during feeding.
  • Once sucking has commenced, insert the finger with the feeding tube or the syringe tip against the feeder's finger. (Note: if the feeding tube is being used it can also be gently slid in the corner of the mouth while the infant is sucking on the finger)
  • GENTLY push very small amounts of milk (approx 0.5ml) into the infant's mouth to stimulate continued sucking only if needed.
  • Follow infant's lead with sucking bursts - only push milk in when infant is sucking if needed, or stimulate suck recommencement by massaging the palate.
  • Suction generated by the infant's sucking will sometimes draw the milk from the feeding receptacle.