I HAVE worked in a NICU and this is my take on this situation. May I also add
that I am also a La Leche League Leader (20 years), IBCLC for 14 years and
newly graduated RN.  I do believe that you can work this out without bottles
but a finger feeder is not the answer since babies of 34 weeks gestation
don't have the suckling "sustainability" that a baby closer to 37 weeks may
have. I would be very careful with cup feeding as well.
    The fact that this baby is 6# or more is kind of a yellow flag to me, did
she have gestational diabetes? I grow weary of the "cookie cutter" solution
to a baby's problem. Every premie is different, there are similarities
however and perhaps we can be flexible while building up to a fully breastfed
baby. This mom needs to communicate with the HCP and find out what the care
plan is. This baby may be perfectly able to take NG feeds to top off nursing
attempts in order to avoid bottles. It is wonderful that she is so dedicated
and focused on breastfeeding.
    Pumping colostrum is an iffy thing, many people are shocked at the small
amount. I much prefer hand expressing either into baby's mouth or a spoon to
feed to baby. Just a quick note, don't have lots of time to go into more
detail but wish her much luck.
Mary Kay Smith, RNLP, IBCLC
Romeoville IL near Chicago

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