I wondered if someone out there has some words of wisdom with this difficult case I saw today. I will just give the most pertinent information. This is the mother's fourth baby, exclusively breastfed, 6 weeks old, and still significantly below her birth weight. The baby is otherwise bright and alert and meeting her milestones. The baby seems to feed well at the breast, and has at least 6-8 very wet disposable nappies, plus a couple of breastfed bowel motions/day. The interesting thing is that all three of the other children have had failure to thrive, one not regaining his birth weight until over 3 months of age. At that stage he was entirely formula fed, plus having medium chain fatty acid preparations naso-gastrically overnight. Introduction of solids also had very little effect on weight gains. The next baby also received naso-gastric supplementation. Although numerous investigations were done, no specific diagnosis was ever reached. At one stage the FTT was thought to be caused by a pancreatic insufficiency, but later discounted. By the time the children reach 12 mths they are thriving. The mother really wants to continue to breastfeed this baby as she feels her supply is not the problem, and changing to formula in the past has not helped her babies. She would like to supplement the baby with MCT mixed with a little breastmilk with a syringe or feeding tube. Does any one have any experience with this, or any other suggestions which will increase the weight on this baby without compromising breastfeeding. The mother is a well educated nurse who has read extensively. Her husband has a PhD in a science of some description. She is seeing the paediatrician for the first time on Tuesday. Thanks for your help Wendy Brodribb Toowoomba, Queensland, Australia, where the first signs of autumn are appearing. *********************************************** 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