I have seen hcps add powdered formula to regular formula to increase to a
higher calorie formula - say 22,24, or even 28 cals per ounce. I think this
is what the pedi is shooting for.  Still, since the mom has lots of milk it
seems this is a baby problem, and has been from the beginning with poor
latch, popping off, etc. The "fortification" may be a short term solution to
the weight gain problem, but still the cause of the problem needs
investigating. What about oversupply /overactive letdown issues. Sure seems
mom has lots of milk to pump and maybe poor feeding started wtih these
issues and now baby is not getting to much hindmilk. Maybe mom could
lactoengineer her bf mgmt too.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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