I think the most significant thing is the baby's weight. Correct me if I am
wrong, because I am guessing he weighed around 5 lbs at birth, at 36 wks
gestation. If he was alot smaller, he may have also been small for
gestational age.
He is now a few ounces more than that, at 3.5 wks old. I would continue to
protect the milk supply by regular expressing, and I would have the mother
use paced bottle feeding to frequently feed and closely monitor as
baby gains weight. I would have the baby doing skin to skin and
breastfeeding too, but mostly worrying about the milk intake via the bottle
for the immediate future. I believe the milk transfer will improve as baby
gains weight, strength, coordination.
I don't generally recommend a bottle as a first method of supplementation.
This case is dealing with a baby almost a month old.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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