Lactnetters,
    I realize that our field of expertise is not abm, but I have a question
about its use.  Answers are not requested for or by a client, but more for
my education/enlightenment.
    First a little background.  A former client has a 7 mo with a cleft
palate and Pierre Robin Syndrome.  The pregnancy was achieved via IVF, and
the birth was slightly premature.  Mom was prescribed Reglan but did not
take it for very long due to side effects--terrible gas.  Her milk supply
was never plentiful, and the baby was put completely on abm as soon after
birth as well-tolerated.  The baby (a beautiful little girl) has a
tracheotomy and is almost exclusively tube fed; she shows little interest
in oral feeds.  The baby has reflux and lots of gas, for which she receives
medication.
     The specialists who will do the surgical repairs will not do surgery
until the baby's weight is "consistent with" her size in length.  BTW, mom
and dad are not large people; mom is petite and dad is probably a slim 5'9
or 5'10".  The baby currently weighs ~ 12# and the doctors say she should
be 14#, so they want to speed up weight gain.  She is getting S------ w/
Iron, liquid concentrate, a 13 oz can reconstituted with only 9 oz water
instead of the manufacturer's recommendation of equal parts concentrate &
water.  Now the doctors may alter the ratio and lower the amount of water
even more so that the baby will get more calories/oz. and put on weight faster.
     Wouldn't under-dilution of abm put excess solute load on the
kidneys?  What are other possible adverse effects of improper
dilution?  Does any of you know about this sort of thing as a "treatment"
for "slow weight gain" in babies fed abm?  To my knowledge, the family has
not looked into banked human milk as a supplement for the baby.

Thanks.
Sara Reuning in Bristol, TN

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