Kathy, does this also apply to borderline premies? The one I have a question about is 4 days old, born at 36 weeks. Very sleepy at the breast (mom is bottle feeding & restarting breastfeeding - long story) and most feeds, feeds better at night. Would a nipple shield help this baby nurse better (saw him nursing - I am glad this baby is also getting bottles). Felicia Henry Oxnard, CA Felicia, It doesn't apply as strongly with a borderline premie, although these babies can have stamina issues as well. If a 36 weeker is in our Intermediate Care Nursery we try to establish breastfeeding before giving bottles and supplement by gavage. Occasionally a 36 weeker will be a gang busters breastfeeder--more commonly they are sleepy with decreased stamina and may not be consistent. As mom's supply increases, nursing often improves, esp. if we can keep bottles away. I wouldn't be against trying a shield with a 36 week baby but if s/he can maintain a latch without it I would hold off. I remind mom that her baby will only get bigger and stronger. I also use breast compression and have mom pump after most feedings to enhance supply. We often have 36 weekers in our normal newborn nursery and they get an automatic lactation consult because they are at high risk for poor intake at the breast at first. With early and consistent support and discharge follow up (which sometimes involves short term supplementation (preferably with mother's milk) these babies can do great. We don't use shields with them. If a 36 weeker ends up in a special care nursery in our hospital they are usually smaller or sick. Kathy Boggs, RN, IBCLC Mountain View, CA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html