Kristen, I think you have a few options.  
    Having the mother breastfeed and then pump to offer  her own breast milk 
sounds like the best you mentioned.  If you have the  mother stop the 
breastfeeding when there are no more signs of swallowing and  then double pump for 
10-15 minutes, that is not an exhausting plan for a  mother.  This plan is a 
win-win one.  The baby gets all breast  milk.  The pediatrician is happier knowing 
the baby is getting extra milk  and therefore more willing to allow the dyad 
to go home.  The mother does  not compromise her milk supply by giving formula 
supplements.
    When a pediatrician orders formula supplementation  after breastfeeding 
without having the mother pump, is putting the mother in a  weaning situation.  
This also needs to be educated to the nursing  staff.
    You could do some test weights.  If the baby  did not transfer milk well, 
I would not do the post weight, it could be  discouraging.  Pre and post 
weights are great once the mature milk is  in.
    What I did not see in your options is what does the  mother think would 
be the best plan.  It appears that others are making  assumptions for her.  I 
think it is always best to give the mother all the  information and allow her 
to make the best decision for herself and baby.
    Hope that helps.
Ann Perry, RN IBCLC
Boston, MA

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