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7.5.3 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 inappropriate sucking technique.

In a NICU...

Breastfeeding rates on discharge home increased by 30% when this NICU replaced bottle feeding with finger feeding for their preterm babies.1

Finger feeding can be considered as an alternative to cup feeding.2

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 has severely damaged nipples requiring rest during healing process - this is helpful to the mother 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

Equipment

  • Syringe
    • regular or periodontal curved-tip, OR
    • feeding line attached to syringe or other milk receptacle
  • Supplement
  • Pillow or towel roll
  • Gloves (for all except infant's own parents)

Preparation

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

Warm the supplement and draw it up into the syringe. If a feeding line is being used - attach line to milk receptacle and tape distal end to finger.

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 nail-side down and soft pad of 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 syringe tip against the feeder's finger. (Note: If feeding tube were being used this would have been taken into mouth with finger)
  • Push very small aliquots of milk (approx 0.5ml) into infant's mouth to stimulate continued sucking.
  • Follow infant's lead with sucking bursts - only push milk in when infant is sucking, or stimulate suck recommencement by massaging the palate.
  • Suction generated by infant's suck will sometimes draw the milk from the feeding receptacle.

Important tip!

The infant oral cavity is very sensitive. Fingers come in all different shapes and sizes so to avoid confusion and desensitization of the infant, limit the number of different people who perform this procedure.

Parents are very capable of taking on this task and teaching them will ensure consistency of technique and give them confidence.


© H.Darby, dad

Notes

  1. # Oddy WH et al. (2003) Implementing the Baby Friendly Hospital Initiative: the role of finger feeding.
  2. # Marmet C et al. (2000) Assessing infant suck dysfunction: case management.