Hi Amy,
The LTP management is  often a  struggle.  
What I find is that there is a 'standard' protocol, but  it varies so much baby to baby.  I haven't done statistics, but find the Haitian and Latino newborns fare better with minimal weight loss and feeding issues.   

My usual is to have them do skin to skin often and frequent feedings.  Depending on how well the baby is nursing, I have them begin hand expression and/or pumping.  If weight loss is an issue, I do often limit feeding time and complimentary feed after a 20min feeding.  I know hand expression is important, but I find many of the moms I encounter are not comfortable with it and prefer pumping.

My question is how are others giving complimentary/ supplementary feeding?  
This is another hurdle, and often discouraging and overwhelming to new parents.  Feeding, pumping, supplementing.  
I like tube @ the breast, but parents (and other staff) prefer tube & finger feed or a bottle.   Are others giving nipple shields also for preterm and LTP? 
  
Kudos to the Mom that just wanted to feed often!  I often find moms resistant  skin to skin and q2h feeds  due to visitors,"need to sleep a few hours"  etc.  

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