Pat wrote:
"What are your suggestions for strengthening his suckle at the breast? How
 can we help him to know that vigorous suckling at the breast is the place
 to do it. Will the use of the supplementer at the breast keep him
 inefficient in his suckle?  Will the present pattern allow him to comfort
 suck and sleep at the breast while he waits for the "real" feeding with
 finger or Haberman?  Will keeping all of his feedings at the breast show
 him, in time, that breast is where it happens and vigorous suckling pays off?"

Pat,
Sometimes, I find it helps to turn everything around by feeding the baby some of the supplemented milk before the breastfeeding, so that he is not so edgy and hungry. Mom can finger feed a bit from the tube, then use it at the breast for a bit, then let the baby nurse to finish the feeding, using breast compression, so that his feeling of satiety comes at the breast. I would also see if mom would use rescue remedy before latching to encourage her to relax and her MER.
Jennifer Tow, IBCLC, CT, USA

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