I would hope that this mom has been kangarooing with her surviving premie on 
a daily basis. Also, now would be a good time to initiate non nutritive 
suckling at the breast. Both of these activities will encourage him to be 
comfortable and secure at the breast when breastfeeding does occur. Please encourage mom 
to advocate for breastfeeding as first choice when he does start po feeds. No 
reason why he has to have bottles first. Bottles can be introduced when he is 
getting enough po feeds per day that mom cannot be there for all the 
feedings. We work with alot of premies that have been intubated for extended periods 
of time and have the high groove in their palate. Time and nipple shields 
overcome this problem. We frequently have premies go home exclusively 
breastfeeding. Tell her good luck.

Chris Smith, RN, IBCLC, RLC
Columbus Children's Hospital

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