Dear Katie,

If this is an older baby ( 7 to 12 months) struggling to gain weight 
inspite of good milk production on the mother's behalf, zinc 
supplementation ( or feeding foods rich in zinc: liver, red meat etc) might 
help. I have just come back from the ABM conference where Dr Nancy Krebs 
presented her excellent paper on Zn deficiency in some breastfed infants.

About the powder + EBM, it can be done safely upto a concentration of upto 
28 cal/oz. Don't have any EBM ( evidence based medicine) to back that up 
but have seen in done in children with problems. Breastmlk has a low solute 
load so it is bettre to do it with breast milk than with AIM powder alone. 
It may not be necessary for this baby though.

Hope this helps

VAishali Kute, MD FAAP IBCLC

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