I read my previous post and it's not really clear.  The baby in question is
now nearly 6 mos old and almost 11 lbs.  He is a pretty sturdy little guy
now, not a tiny preemie anymore.  He is mostly breastmilk fed by bottle -
which is of course how the NICU staff insisted he be fed prior to discharge.
 (Another case of very little breastfeeding support in NICU)
I don't think this is a case of mom inappropriately giving supplement after
breastfeeding.  He cries and struggles at breast, latches and sucks poorly,
and pretty much holds out until a bottle is given.  I think this is more a
case of nipple preference than any problem with mom's supply or baby's
anatomy at this point.  The mom is considering giving up direct
breastfeeding, and exclusively pumping (which she has pretty much been
doing.)  She's looking for ideas to encourage him to breastfeed better,
preferably without any gadgets required permanently.  She did try a nipple
shield, and he doesn't like it and resists latching with it.

Jennifer Tieman
Family Physician
Mom to 4, including my toddler nursling Caroline Rose

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