I would suggest to the mother that she say to her baby's nurse: "Do not 
begin any bottle feedings until I have spoken to the neonatologist. Please 
have him/her call me right away. If ordered, you may do gavage feedings. "
Then mom could speak to the neo about her desires to breastfeed. She could 
share baby's respiratory s/s and his feeding behaviors. She could say she is 
familiar with reserach and nicus that use gavage/bf instead of bottles. She 
could ask that they try this for a few days. If she is very available to the 
baby, she could be there to do lots of practice bf and STS.
She *might* also say to the doctor that they could start bottle later (give 
in a little) if it becomes apparent after a few days that it is needed (is 
it ever realy needed?).
Not sure how sick the baby is, but may improve in just a few days. Make sure 
mom initiates and continues milk production with an aggressive program of 
regular milk expression and using an effective pump.
In my experience, many neos don't talk directly with the parents much. They 
are quite busy with large nurseries and sick babies. However, if the parents 
are pro-active, the neo will likely listen and write orders as such. The mom 
should also try to establish a good rapport with the nurse, ask for a 
primary nurse to be the one to mostly care for her baby if possible. Hope 
she is successful. It is her baby.

Laurie Wheeler, IBCLC, MN, RN
n.e. Mississippi, s.e. USA

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