Earlier this year I worked with a mother whose baby was born at 33 weeks.
She had a previous baby also born prematurely, who was supplemented in the
hospital, and she had spent three or four months trying to get completely
weaned from the supplements after they went home.

She did not want to get into the same pattern with this baby. She pumped
more often this time, and had lots of milk, but the baby was discharged with
the same feeding pattern you described - nursing, then getting some pumped
milk from a bottle. The baby was not using a nipple shield, though.

When we talked, it was clear that she had plenty of milk for the baby - they
were not using any formula. The concern was: would her baby be able to get
the milk without overtiring? She decided that the least stressful
environment for the baby would be kangaroo care - skin-to-skin with her 24
hours a day. She also decided to breastfeed him without restrictions, so he
could have frequent small feedings (increasing the fat content of the milk)
and to use breast compression during feedings to help with milk transfer. He
did nurse very frequently, for short periods of time. While she could not
afford to rent a scale, she took him in to the doctor's to be weighed once a
day for the first three days. After that it was obvious that he was gaining
well and she never looked back. At four months, he had tripled his birth
weight and is today a lovely, chubby, healthy little guy.

Teresa Pitman

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