Dear lactnetters,
I'm a midwife and lactation consultant in private practice in Germany and
because of my profession not so very much familiar with the care and
breastfeeding management of preemies. Right now I am working with a mother
of a preterm baby girl, born 4 weeks ago at 28 weeks of pregnancy, birth
weight 1018g, then dropped to 800g and is now at 1300g only on her Mom's
milk!!! She is quite fine except still needing some help with breathing.
The NICU-nurses  now told these parents it would be better to gavage feed
her while she is sucking on a pacifier and she should also get a pacifier
for oral stimulation so she won't loose her suck reflex. Parents would
prefer not to give her a pacifier but of course don't want to do anything wrong.
Here are my questions:
1. Is there any clinical experience or scientific research pro or versust
the use of pacifiers with preemies?
2. Is it possible to loose the suck reflex if the baby does not get a
pacifier though it is put to breast for comfort and later to nurse as often
as possible?
3. What advise do you give parents of preemies regarding pacifiers?
Another thing is: NICU-nurses want to try orally feeding the baby with drops
of milk from a bottle nipple without a bottle before nursing from the breast.
4. Is that a usual technique? And wouldn't  it be better to go right to the
(perhaps emptied) breast?
TIA for any answers,
I would greatly appreciate them by private eMail as well as to the list,
because I'm almost a month behind reading all the postings,
greetings from Hamburg, Germany,
Regine Gresens, IBCLC.

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