Linda Pohl posted on a baby with Down's syndrome who is not growing well,
and asked for input about ways to increase the caloric content of the milk.
Human milk is a finely tuned physiologic fluid, with electrolytes and
nutrients in balance so that the baby's digestive, circulatory and renal
systems are minimally taxed on consuming it.  There are very low obligatory
fluid losses when consuming breastmilk, in contrast to formula and many
other foods, which require much more water into the system in order to
process the metabolic waste products from the food.  Heating breastmilk to
reduce the water content could be literally playing with fire.  Condensed
cow's milk can cause life threatening electrolyte imbalance in babies, as
can formula that is too concentrated.
If the mother has an ample supply, why not try simply increasing the fat
content for a short time and see what happens? It could be that the baby is
getting adequate protein but is not gaining because there isn't enough
energy going into the baby to support growth.  Increasing fat content of the
milk will spare the baby having to burn protein for energy, and the end
result would be weight gain.
All this could be done at the same time you are pursuing investigation of
other causes for the baby's delayed growth.

Also, please keep in mind that rapid growth is not always a perfect sign of
optimal health in all babies.  Yes, we are supposed to grow.  We differ in
our rates of growth.  This baby may even be growing at the right rate for
him.  Ruling out underlying pathology is essential.  Assume nothing and look
at the whole picture.

cheers
Rachel Myr
back at my desk in Kristiansand, Norway, after a very exciting trip to the
Bellingham BF Conference  :-)

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