Medela Supplemental Nursing System User manual

EN Instructions for use
Master file
Supplemental
Nursing System™
because breast
milk is best for
your baby

Thank you for choosing the Supplemental Nursing System (SNS). The SNS is a feeding solution
that enables more babies to breastfeed and to stay motivated to do so.

EN
4 – 20

4
1. Intended use / Population – Contraindications 5
2. Meaning of symbols 6
3. Important safety information 8
4. Product description 9
4.1 Product parts 9
4.2 Material 9
5. Cleaning 10
5.1 Cleaning at home 10
5.1.1 Beforeusingforthersttime 10
5.1.2 After each use 11
5.1.3 Once a day 11
5.2 Cleaning in the hospital 12
5.2.1 Beforeusingforthersttime 12
5.2.2 After each use 12
5.2.3 Once a day 12
6. Assembling the SNS / Preparing for feeding 13
7. Feeding 16
8. Disassembling the SNS 20
9. Disposal 20
10. Product variants and consumables 20
11. Technical specications 21
Table of Contents

5
The intended use of the Supplemental Nursing System
The Supplemental Nursing System is designed to administer supplemental nutrition
to babies while they are being fed at the breast. Its intended use is to enable
mothers to breastfeed when they would otherwise be unable to do so. The SNS
can be used for suckling training and also to stimulate the mother’s milk pro-
duction. In all cases, the SNS helps to maintain the unique skin-to-skin contact
between mother and child.
Motherscanusethesystemwiththeirownexpressedmilk,fortiedhumanmilkor
formula.
Intended population / users
The Supplemental Nursing System is intended to be used in cases where babies
have weak suction or cannot maintain vacuum long enough. The SNS can also be
used by mothers with poor milk supply and to feed adopted babies.
Contraindications
The SNS cannot be used by mothers who are unable to breastfeed because of a
medical condition. Also, mothers who take medicines to which babies are intolerant
must not use the SNS.
1. Intended use /Population – Contraindications
More information in your language:
More information in your language (DA):
More information in your language (FI):
More information in your language (NO):
More information in your language (EL):
More information in your language (JA):
Or visit our homepage www.medela.com /sns

6
Caution
Failure to follow instructions of this type can lead to (minor) injury or
contamination/growth of bacteria.
Note
Failure to follow instructions of this type can lead to material damage.
Info
Useful or important information that is not related to safety.
Symbols on the packaging
This symbol indicates that the material is part of a recovery/recycling
process.
This symbol indicates a carton package.
This symbol indicates to keep the device away from sunlight.
This symbol indicates to handle the fragile device with care.
This symbol indicates the temperature limitation for operation,
transport and storage.
This symbol indicates the humidity limitation for operation, transport
and storage.
This symbol indicates the atmospheric pressure limitation for
operation, transport and storage.
i
Thewarningsymbolidentiesallinstructionsthatareimportantforsafety.Failure
to follow these instructions can lead to injury or material damage. There are several
warningsymbols.Eachsymbolisusedtogetherwithaspecicword.Thewarning
symbol/word combinations stand for:
i
2. Meaning of symbols

7
This symbol indicates to keep the device dry.
This symbol indicates that the product material is approved for food
contact.
This symbol indicates the unique GSI Global Trade Item Numbers
(GTIN).
This symbol indicates to consult the instructions for use.
This symbol indicates the manufacturer.

8For your child’s safety and health
WARNING!
Failure to follow the information below can lead to danger from the device
The SNS is not heat-resistant: keep away from radiators and open
ames.
Do not expose the SNS to direct sunlight.
Check the components of the SNS for wear or damage. Never use a
defectivedevice.Throwapartawayatrstsignsofdamageorweakness.
MAX.
30 days For hygiene reasons, we recommend replacing the tubing after 30 days
(home use), or every 24 hours (hospital use).
We do not recommend using the SNS by more than one person, as this
may present a health risk.
Always use this product with adult supervision. Keep all components not
in use out of reach of childern.
Contact your lactation consultant or physician if you experience problems
or pain.
Important
IThe SNS is not a storage device, but a feeding device. Do not use it to store milk.
I Plastic bottles and component parts become brittle when frozen and may break
when dropped.
IAlso, bottles and component parts may become damaged if mishandled, e.g.
dropped, over-tightened or knocked over.
I Take appropriate care in handling bottles and components.
l Do not use the breast milk if bottles or components become damaged.
I Always check the food temperature before feeding (danger of burning).
I Do not warm milk in a microwave. This may cause uneven heating and could
scald your baby.
3. Important safety information

9
4.1 Product parts
1x Feeding Bottle
4. Product description
1x Attachment Ring
1x Valve Holder
3x Valves with Tubing
red = small, white = medium,
transparent = large
For product variants, see chapter 10
1x Cover
1x Paper Tape
1x Neck Cord
3. Important safety information
4.2 Material
INeck Cord: Nylon, metal
IFeeding Bottle/Attachment Ring/Cover: Polypropylene
ITubing: Silicone
IValves: Polypropylene
IValve Holder: Silicone
IPaper Tape: Paper

10
5.1.1 Before using for the rst time
IDisassemble* the SNS into its
individual parts.
IRinse all parts with water.
IFill the bottle with 50 ml of water.
Screw the attachment ring with
the tubing onto the bottle.* Shake
it for 5 seconds, then squeeze the
bottle for 15 seconds to force the
water through the tubing.
IRemove the valve and tubing from
the ring;* place all SNS parts in
a pan; cover all parts with water
andboilforveminutes.
IRemove the pan from the stove and
drain the hot water from the pan.
ILet the parts cool down in the pan.
IDry the cooled-down parts with
a clean cloth or leave to dry on
a clean cloth.
5.1 Cleaning at home
1
IClean all parts immediately after
use to avoid drying up of milk
residues and to prevent growth
of bacteria.
IOnly use drinking-quality water
for cleaning.
IIf you clean the SNS parts with
boiling water, be careful not to
burn yourself.
IStore the clean parts in an air-
permeable, clean bag/container,
or in an air-permeable, clean
paper/cloth until next use.
Caution
i
lWhen you boil the parts of the
SNS, you could add a teaspoon
of citric acid to avoid a build-up
of limescale. When you use citric
acid, minor traces might remain
on the parts. Use drinking-quality
water to wash them off. Dry the
parts with a clean cloth or leave
to dry on a clean cloth.
IDo not leave (parts of) the SNS
in direct sunlight or heat, as this
may weaken the parts.
IDo not use chemical sterilisers.
Note
1or
*For more information about assembling and disassembling the SNS, see chapter 6 and 8, respectively.
5. Cleaning

11
Use a Quick Clean microwave
bag** in accordance with the
instructions.
2b
2
** More information at www.medela.com
5.1.2 After each use
IDisassemble* the SNS into its individual parts.
IRinse all parts with warm, soapy water (approx. 50°C). Use
8 ml of dishwashing liquid per one litre tap water.
IFill the feeding bottle with 50 ml of soapy water. Screw the attachment ring
with the tubing onto the bottle.
IShake the bottle for 5 seconds, then squeeze it for 15 seconds to force the
soapy water through the tubing.
IRepeat steps a-d using cold tap water.
ISqueeze the empty bottle a few times to remove water droplets from the
tubing.
IDisassemble the now clean SNS into its individual parts.
ILeave to dry on a clean cloth.
5.1.3 Once a day
First clean the SNS as described in chapter 5.1.2, then clean the system as
described in chapter 5.1.1.

12
5.2.1 Before using for the rst time
IDisassemble* the SNS into its
single parts.
IRinse all parts with water.
IFill the bottle with 50 ml of water.
Screw the attachment ring with
the tubing onto the bottle.*Shake
the bottle for 5 seconds, then
squeeze it for 15 seconds to force
the water through the tubing.
IRemove the valve and tubing
from the ring.*Wrap all parts in
a sterilisable pouch. Sterilise all
parts by autoclaving at 134 °C
for 3 minutes or according to the
internal hygiene guidelines.
5.2.2 After each use
See chapter 5.1.2. (on page 11).
5.2.3 Once a day
You must sterilise the SNS once a
day by autoclaving. This is usually
done when you change the tubing.
5.2 Cleaning in the hospital
IClean all parts immediately after
use to avoid drying up of milk
residues and to prevent growth of
bacteria.
lOnly use drinking-quality water
for cleaning.
IHospital: To avoid cross-contami-
nation, replace the tubing/valve
set by a new set every 24 hours.
Clean the newly assembled SNS
as described in chapter 5.2.1.
IWhen you are cleaning the SNS,
check all parts for damage.
Throwawayatrstsignsof
damage or weakness. Replace
the damaged part by a new part
and clean the SNS as described
in chapter 5.2.1.
Caution
i
IDo not leave (parts of) the SNS in
direct sunlight or heat, as this may
weaken the parts.
Note
*For more information about assembling and disassembling the SNS, see chapter 6 and 8, respectively.
5. Cleaning

13
lWash your hands thoroughly (for
approx. one minute) with soap
and water before you touch your
breast and the SNS parts.
Caution
i
lAssemble and prepare the
Supplemental Nursing System
(SNS)attherstsignofyourbaby
being hungry.
Note
6. Assembling the SNS / Preparing for feeding
2
Place the silicone valve holder
onto the valve.
The SNS is supplied with three
sizes of tubing: small (red valve),
medium (white valve) and large
(transparent valve). When you use
theSNSsystemforthersttime,
start with the medium (white) valve.
1

14
Slide the tubing with the valve on
top through the attachment ring.
Push the valve in until it snaps into
place. Do not pull on the tubing.
6. Assembling the SNS / Preparing for feeding
IThe Supplemental Nursing
System is used to administer
supplemental nutrition to infants
while they are being fed at the
breast. Prepare the supplemental
nutrition in a separate milk con-
tainer. To avoid clogging, dissolve
powdered formula thoroughly:
Caution
Mix suppliment in separate container and then transfer it to the bottle
Ensure that the suppliment is thorougly disolved and there are no lumps
lHeat the supplemental nutrition to
max. 37 °C.
I Do not warm breast milk in a
microwave or a pan of boiling
water to avoid loss of vitamins,
minerals and other important
ingredients and to prevent you
and your baby from burning
yourselves. For the same reasons,
do not thaw frozen breast milk in
a microwave or a pan of boiling
water.
3
Lock both parts of the tubing in the
slits of the attachment ring. This is
to avoid milk leakage as you hang
the SNS around your neck.
Place the SNS system around your
neck with the tubing hanging down.
6

15
Fix the neck cord on the bottle:
Pull the cord with its soft ending (without
the clip) through the hole in the bottom
of the bottle. Pull the ending with the
metallic clip through the cord loop you
createdinthepreviousstep.Pullrmly
untilthecordisxed.
54
approx
1 cm
Check that the bottle shoulder is at nip-
ple level. To raise the bottle, unlock the
lock of the cord and move the entire lock
downwards. To lower the bottle, move
the (unlocked) lock upwards. When the
bottleisintherightposition,xthelock:
Cut off a piece of tape of ap-
prox. 6 cm. Place the tube onto
the breast such that it protrudes
from the nipple by 1 cm. This is to
prevent the (extended) nipple from
blocking the tube opening during
feeding. Repeat this step for the
other tube and the other breast.
Fill the bottle with the supple-
mental nutrition which you pre-
pared and heated in a separate
container. Screw the attachment
ring with the valve and tubing
onto the bottle. Squeeze the
bottle gently, so that the milk
owsthroughthetubing.Ifyou
use powdered formula, the for-
mulamaybetoocloggytoow
freely. In this case, dissolve the
powder more thoroughly.
78

16
Assemble the SNS according
to the instructions in chapter
6. Hold your baby close to
your breast. To encourage
your baby to open its mouth,
tickle its lower lip with your
nipple. Leave a tiny space
between the nipple and your
baby’s mouth.
Hold baby close to breast
1
i
I If you use the SNS at home in a private
environment, supervision by a professional
midwife or lactation consultant is
compulsory.
Note
IClean all parts immediately after use to
avoid drying up of milk residues and to
prevent growth of bacteria.
Caution
7. Feeding

17
Wait until your baby opens its
mouth wide, then put your baby
onto your breast. Only when
the baby’s mouth is wide open,
allow it to latch-on. A good
latch-on position is essential for
successful feeding. This requires
your baby to accept both the
breast and the tube.
Only when baby’s mouth is wide open allow the latch
2
Check that the tube position in the
baby’s mouth is correct: the tube
should enter the mouth in the middle
of the upper lip or at the corner.
Note that you and your baby have
to familiarise yourselves with the
SNS. If you have difficulties in finding
the right position, release your baby
from the breast and try again. It is
important to try again and again, but
without applying pressure.
The tube should enter baby’s
mouth in the middle of the upper lip,
or at the corner
3

18
7. Feeding
Info
Flow regulation
Youcanregulatethemilkowasfollows:
To increase the milk ow:
I Squeeze the bottle;
IRaise the bottle: unlock the cord lock at
the back of your neck. Move the entire lock
downwards. When the bottle is in the right
position,xthelock;
IUse a larger tubing size (the red valve/tubing
is small, the white one is medium and the
transparant one is large).
To decrease the milk ow:
ILower the bottle: unlock the cord lock at
the back of your neck. Move the entire lock
upwards. When the bottle is in the right
position,xthecordlock;
IUse a smaller tubing size.
i
A good latch is essential for successful feeding
4
Once you and your baby have
found the right position, let
your baby breastfeed. When
your baby starts suckling,
release the tube from the slit
in the attachment ring. The
milk in the SNS bottle can
nowowthroughthetube.
Continue breastfeeding.

19
7. Feeding
5
If the milk does not flow well, also
release the second tube. Attach the
tube with the opening upwards to
your body, on a level with the bottle
bottom.
Also, the milk flow might be too weak
or too strong. For information on how
to regulate the milk flow, see the ‘Info’
column on the left (“Flow regulation”).
After approximately 15 minutes of
feeding, change the breast. Repeat
steps 1–5.

1. Intended Use/Contraindication/Population
20
IRelease the cord from the bottle.
IUnscrew the attachment ring from the bottle.
IDispose of the remaining milk.
IRemove the valve and tubing from the attachment ring: push against the reverse
side of the valve (with the tubing attached) in the ring.
IRemove the valve holder from the valve.
IClean all parts as described in chapter 5 “Cleaning”.
9. Disposal
Dispose of the SNS in accordance with the local disposal regulations.
10. Product variants and consumables
The following product variants and consumables are available from the Medela
distribution partners. To order a product, specify the name or corresponding
number.
Product variants
Article number Product
009.0005 SNS (EN/DE/FR/IT/NL/ES/PT/SV/PL/RU/KO/ZH)
Consumables
Article number Product
xxx.xxxx Tubing/Valve Set (with small, medium and large tubing)
More information about other Medela products are available on our website www.medela.com.
8. Disassembling the SNS