I have posted several different times about my friend's baby, born at 25 1/2 weeks as one of triplets who is the only survivor. He has been home now for 3 weeks, and was 40 weeks corrected age yesterday. He was born 10/29/05 and is 3 mos old. I'm back with more questions! Zachary was born at 780 gms(1 lb 11oz), and today weighed 2900 gms (6 lbs 6 oz) He has been averaging in the last 4 weeks just about an ounce a day weight gain. He is fed his mother's milk, half at breast, half by bottle. He had been nursing fairly well, but seems to have developed some nipple confusion recently, and tends to pop on and off the breast and root frantically. He is on oxygen due to BPD, and takes Diuril and potassium phosphate. His neonatologist wants mom to supplement half of the baby's feedings with powdered formula to increase the calories in the breast milk. Mom has tried Enfacare and Nutramigen, adding 1 tsp of powder to each ounce of milk. Baby seems fairly unhappy when receiving supplementation, fussy and gassy. Several times she has stopped the supplement altogether for a day or 2 and he is much happier. She would like to go to exclusive breastfeeding, but the neo wants the baby supplemented until he is 8 lbs. They advised her today to try Good Start Soy, so she bought some but hasn't started it yet. She was really hoping today that the neonatologist would agree to let her go to exclusive breastfeeding and monitor baby's growth, but they are adament that he needs the extra calories until he is 8 lbs. She's also worried that his recent struggling at breast is only going to get worse if he continues to receive significant amounts of bottles. Is anyone aware of standards for supplementation in the breastfed preemie? Is there any evidence based guideline I could point her to that might help in deciding how important this supplementation is? What do those of you who work in NICUs do? And in light of the recent discussion of non-sterilility of powdered formula would there be a safer product to use for supplementation if it is necessary? Jennifer Tieman Family Physician Mom to 4, including my toddler nursling Caroline Rose *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html