Regarding the growth of one year old with Down Syndrome and heart surgery. Has she plotted his growth on a Down Syndrome growth chart? Is his rate of growth within normal limits? Could he be supplemented with something thinner? Have you thought about using one of the handy-dandy new scales to weigh him and ascertain breastmilk intake? Is this really a problem?- a 15 lb one year old whose had heart surgery sounds pretty good. Has mother tried massage before or during breastfeeding to increase fat content in milk? Has she thought about expressing or pumping after feeding to collect more hindmilk and using a supplementer to add this during a feeding? Surely there is a solution that will allow mother to maximaze breastfeeding and meet her baby's needs. Cathy Liles, IBCLC College Station, TX