The WHO recommendations are just that, and apply to healthy, full term 
infants. Not this mom's concern.

  I am  unconvinced that starting solids, especially if there is concern 
about babies digestion at present, will solve the problem. In part 
because the typical early solids, in western culture anyway, tend to be 
very low KCal,  and nutrient poor. Even healthy infants will stop 
gaining, or lose weight, after solids are introduced. So solids may be 
a better choice in some places than others. :)

Other ideas that might be more beneficial include the very frequent 
nursing that this baby needs. Keeping them very easy, with rest 
periods, and lots of breast compression when the baby is ready for the 
extra flow.

  I would also consider using an SNS, and fat fortified EBM. THe mom 
would need to really work to do this. Pumping twice, skimming the first 
milk and adding the fat to the second milk, which is then used during 
feedings to increase intake. Probably need to start with the slow flow 
setting.  The skimmed milk could be frozen for later use with cereals 
etc. as baby gets older.

If all of the pumping and supplementing seem to be too much for this 
mom, an appropriate formula could be used instead, the key is a few 
extra Calories per feed.



Victoria Fisher

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