First feed the baby, then get mom's milk moving (hand expression is 
sometimes very helpful for moms who don't do well with pumps), and 
finally see if you can get baby to do a better job on the breast. A 
hospital grade pump might help (Ameda kits fit all their pumps, so mom 
could rent one for a short time and use her PY kit).

This dyad is a good candidate for a nursing supplementer, particularly a 
syringe and tube where mom could give the baby a little bolus of milk 
for any sucking effort. Nursing with a tube at breast might help the 
baby organize around the flow and get into a nice suck:swallow rhythm, 
which could improve his strength and stability.

Once the baby has grown better, he might do a better job.

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

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