I have a question for you. I wanted to ask the Pediatrician but I had left for 
the day before she had made her rounds. I followed up on a mom that was 
discharged approx. 10 days ago. I had given the mom a manual harmony pump 
because she had been bottle feeding her baby and hadn't made up her mind 
whether or not she wanted to breastfeed. I discussed putting baby skin to 
skin but she said he didn't want anything to do with it and she would open a 
bottle. When her milk came in she wanted to pump the milk and bottle feed it 
to the baby. I called just to see how the pumping was going and if she had 
any concerns or questions. She said she is still pumping but freezing the milk. 
When I asked why she wasn't feeding the baby her milk she said that he 
keeps throwing it up. Dr. told her to freeze it because her milk was too thin.
She didn't give her any explanations of why, how long or suggestions of 
adding cereal or anything. She seemed to be ok with what her instructions 
were. I asked how he was doing with the formula and she said he was keeping 
it down well.
That is my first question. My next is I need a few suggestions. Baby is premie 
of 36 wks. Nursing with nipple shield to keep at the breast, without he latches 
but loses the latch and falls asleep. He can nurse 10-20 minutes using the 
shield. He has an IV, of D10, Came off nasal O2 today. He was 5#15 at birth 
and was down to 5# 3. The last three days he is 5#9, he is not gaining. Mom 
has losts of milk. I have had her pumping after feedings to keep up her supply 
and because of using the shield. Today I tried supplementing her pumped milk 
at the breast during feedings. He would nurse 10-15 min one side and take up 
to 4ml. He is waking every 2-3 hrs. Do you think I am on the right track? I'm 
thinking that because of all the milk she has he is not getting the fat. He is 
voiding and stooling well.
Thanks, feel free to email me privately or post to list.
Terri Klein RN IBCLC RLC

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