Pacifiers are a different issue for premies who are being tube fed.  They are
actually helpful in this situation, both in releiving the pain and stress of
being intubated, and of teaching the infant to link sucking and a full tummy.
 If infants are tube fed and not offered a pacifier, nasty oral aversions and
real difficulties with later sucking can occur.
        In my own practice, I have assisted premies to transition to the
breast even after discharge.  This seems to occur more easily before about 5
lbs than after.  Here in NYC, some progressive hospitals discharge infants
when medically stable, regardless of weight.  I have had infants as small as 3
lb 12 oz and as young as 32-34 weeks g.a. transition to complete breastfeeding
after gavage and then bottle feeding in the hospital.  I wish this were a
perfect world and that NICU staff beleived the research showing that
breastfeeding is easier for premies than bottlefeeding, but many kids are more
resilient than we give them credit.  Please don't anyone misinterpret this and
think I am in favor of routine bottle feeding of hospitalized infants...
        Her supply seems very high.  Maybe pumping on lower suction would
reduce the pain, and single rather than double pumping would reduce the supply
somewhat.  She could use ice packs to increase her comfort.  In the hospital
it is easy - have her grab a latex glove or two and fill them from the ice
machine.
Keep us posted.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]