How do I use a lactation aid or DAL?

What is a DAL?

The DAL consists of a thin tube, one end of which is slipped into a bottle (often a bottle) filled with mother’s or infant’s milk and the other end of which is placed on the nipple at the same time as the baby sucks the breast. Thanks to this device, the child sucks the breast and at the same time drinks the complement through the small tube. This prevents the mother from introducing the bottle into breastfeeding with the risk that the baby will reject the breast later (the famous breast / pacifier confusion).

Why use a DAL?

The DAL can be useful in several cases:

• when getting started with breastfeeding is a bit complicated and the baby is not gaining enough weight just by sucking on the mother’s breasts.
• for adoptive mothers who wish to bond with their baby by putting it to the breast.
• for women who have had breast surgery.
• to help a premature baby latch on and gain weight.
• for mothers who have been forced to stop breastfeeding but wish to resume.

What are the advantages of DAL?

The lactation aid has several advantages for the mother and for the baby. First, it stimulates lactation: the baby sucks on the breast at the same time as he drinks the supplement from the small tube. And we know that only sucking can trigger milk production. This is because prolactin triggers the production of breast milk in response to baby’s sucking. The more milk your baby drinks at the breast, the more likely you are to get large amounts of milk. Another advantage is that this device allows breastfeeding to be maintained even when the baby is not getting enough breast milk. Rest assured, moms don’t have to reluctantly stop breastfeeding because their baby is not gaining enough weight. The DAL is precisely a precious aid that avoids the introduction of the bottle in breastfeeding.
Finally, OD allows the baby to continue to drink breast milk even when he is receiving the supplement.

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How to use a DAL?

• Place the tube on one of the two breasts, at the level of the nipple, making sure that the end protrudes by about 5 mm. To fix it, you can use adhesive plaster. The other end of the hose is immersed in a container filled with breast or infant milk.
• The supplement can be held in the hand or placed on a nearby support (the container should be a little higher than the baby’s head for the milk to flow well). There are DALs, the complement of which can be tied around the mother’s neck.
• Once the device is installed, put the baby to the breast.
• Once he begins to suck properly, slide the small tube into his mouth, at the level of the corner of his lips, and direct it slightly towards the palate above the tongue. If you see milk coming back up the tube, baby is sucking in the milk from the supplement.
• When the OD is working well, moms also report feeling a difference in the temperature of the milk on their nipple.

Setting up a DAL is not always easy, especially the first time. Do not hesitate to call on a lactation consultant to assist you in case of difficulties. The French Association of IBCLC certified lactation consultants provides on its website a phone book lactation consultants per department.

The DAL can also be attached to the finger. This possibility allows the partner (dad or second mother) or the people who look after the child to feed the baby other than from a bottle when the mother has to be away, without compromising breastfeeding. Unlike breast OD, finger OD does not stimulate maternal lactation.

Using an OD with baby

How to make a DAL yourself?

It is possible to buy a DAL in pharmacies or on the internet. The Supplementary Nutrition System (SNS) of the Medela brand is the only one approved in France.

You can also make it at home. For this you will need:

• a bottle or a baby bottle (bottle offered at the maternity ward).
• an enteral feeding tube. If you plan to fill the bottle with breast milk, choose a CH4 probe 40 cm in length. If you want to alternate breast milk supplement and infant milk supplement, opt for a CH5 probe. CH6 probes are recommended if you are giving thickened formula. The speed of milk flow or flow will depend on the diameter of the probe. The larger it is, the faster the milk will flow. If the baby is slow to drink the supplement (more than 30 minutes for 30 ml), increase the diameter of the probe.
• adhesive tape to hold the tube in place on the breast.

Wash your hands before assembling the DAL.
Step 1 : remove the nipple from the bottle then widen the hole with a pair of clean scissors to pass the probe.
2nd step : pass the probe through the hole you have just made in the pacifier.
Step 3 : replace the teat with the probe in the ring of the bottle.
Step 4 : screw the cover with the teat and the probe on the bottle filled with milk (breast or artificial).
If there is breast milk left in the container after feeding, you can store it in the fridge in an airtight container for 8 days.

To clean the OD, use an approximately 20 ml needleless syringe.

How long to use a DAL?

The duration of use of the DAL is made on a case-by-case basis. It can last several days, several weeks, or even the entire duration of breastfeeding. The objective of this device is to provide the milk that the child needs when the quantities of milk taken at the breast are insufficient. When the baby’s weight gain is good and the amounts of milk taken with the OD start to decrease because the baby is suckling well at the breast, you can do without the device. Seek the advice of a healthcare professional before starting to wean the baby from OD.