Christina, I hope you and mother can find a supportive health care provider to help work through the feeding issues with this baby. I would be looking for a cleft of some sort, just because I am reading "between the lines" with the history of pneumonia, you say baby gets a suck of milk, breaks suction, and then again and again, baby gets very tired, chokes, cannot get what she needs, and is experiencing great discomfort. You also say you are not sure the breathing issues are entirely resolved. Alternatively there may be a suck/swallow disorder. I think the reason baby does well with breastfeeding is that the baby can pace, and breathe, but also because baby is not really getting much milk, so doesn't have the breathing problems. Baby will always try to protect her airway, even if she has to underfeed. I agree with you that small frequent feeds would be beneficial, so I would divide her needed 24 hr total into 12 feeds or so. I would also encourage mother to try the supplementer (I like the homemade ones) with you present, and she may feel better after she tries it. However, it wouldn't surprise me at all if baby does not do well when more milk begins to flow. So be prepared for this. I also agree that finger feeding could be used. The mother will have to be taught to closely observe the baby for stress cues, and needs for airway and breathing breaks. I am not sure if baby is clenching her lips and collapsing the bottle nipple due to wanting to protect her airway or possibly some hypertonia problems or back to a suction problem like a cleft. Some clefts are submucosal. I certainly think the baby needs further evaluation. I once had a baby losing weight at followup and when I assessed baby on bottle as mother was feeding that way at the time, no suction was there. I observed a very large cleft of the palate, which no one had seen, and the nurses had said the baby fed fine. There was no way! I just want to say I hate all the inductions or planned births at 38 wks which too often turn out to be a premature baby, as this one did. I hope you can help this mother and baby. Laurie Wheeler RN MN IBCLC Mississippi USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome