Hi,
I would like some suggestions from those of you who work with premature
infants on a regular basis. I have a mom with a 35-week preemie who has
taken off eating with a nipple shield. Baby is discharged tomorrow.

This mom wants to be able to breastfeed exclusively. She has been
pumping between feedings. She saves this pumped milk. She breastfeeds
with the shield for 20-25 minutes, then follows up with 50-60ccs of her
pumped milk.

All too often, I see these moms go home, having supplemental top-offs
given routinely. This is done to get the baby to gain weight quickly for
discharge home. The couplet then becomes "dependent" on the supplemental
feeding, and has a very hard time moving toward exclusive
breastfeeding.

What is the best way to wean this baby from supplements after
breastfeeding? We are going to do a test weight today to see how much
baby is really getting at the breast. I would like to be able to advise
this mother on an exact amount she needs to be topping off with after
the breastfeeding, if it is even necessary. Eventually, I would like to
see her breastfeed, on demand, without the supplement. I will be
following up with her after she has gone home.

Thanks for any input,
Brenda Phipps, BS, IBCLC

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