I posted to the list last week about my premie that wasn't gaining weight x 3 
days. I had mom supplementing at the breast pumped milk that she had been 
pumping after feedings. He could only take one to four ml each feeding. I then 
thought if she offered the same breast until the other breast began to fill it 
may give him more fat. 
She brought him in to see me today and he has gained 5 ounces in the last 
two days. He has resolved jaundice. She has alot of stored milk. I will try to 
get her in touch with a milk bank in our area since I am sure that they are in 
need with 36 wk milk. I am so proud of her. She has been going through alot 
of stress with her home life and then having the baby early as well. She is 
such a good mom.
My second premie is also gaining well. 2 ounces at a 24hrs follow up.
I have another premie that I will be following up on Monday. This baby just 
does not suckle well. Mom has huge pendulous breasts with flat inverted 
nipples. I tried a nipple shield but her areola is not even very pliable to get a 
good fit. He will try with the nipple shield but I am afraid he is getting alot of 
air. I tried bottle feeding expressed breast milk with self paced feeding just to 
get him to suckle well. Mom is good with that. She would rather pump and 
bottle feed. She feels really awkward with the shield. I sent her home with a 
hospital grade pump and formula to supplement if she isn't getting enough milk 
for him. I will see her on Monday as well. I am open to suggestions from you.
Thank you Laurie for your advice on my first little guy.
Terri Klein RN CLC IBCLC RLC

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