>I have permission to post. A mother in the US has contacted me about 
>her son's upcoming cleft palate surgery. He is fed almost 
>exclusively expressed breast milk, occasionally formula when the 
>mother can't pump enough.
>The mother has contacted two surgeons about her sons palate surgery 
>and they both reccomend she fortify her BM "since he's a bit 
>underweight and will need more body weight in order to recover 
>faster after surgery".
>
>He was born at 2.5kg (5lb8oz) and is now almost 3.5 months and 
>weighs 3.9kg (8lb8oz)
>
>I have checked the WHO charts and he was born on the 3rd percentile. 
>According to the chart, at 3.5 months a baby on the third percentile 
>should weigh 5.4kg (11lb14oz).




Yikes.  This baby is way underweight.  Really *seriously* underweight.

You don't say how often she is expressing or what amount of milk she 
is getting.

Clearly, he needs more milk - but the easiest way to get this is to 
express more often which will improve her supply and of course his 
intake.

The concern would be that her supply has been low for a long time and 
she would need to express *often* day and night, both breasts several 
times, and she is already (you say) at the end of her rope with 
regard to pumping.  Maybe this baby should not wait until she can 
build up her supply, 'cos this won't happen overnight.

This situation is outside my boundaries, to be honest, except to say 
that here (and I expect everywhere) this baby would be regarded as 
seriously under-nourished, and this would be regarded as an 
emergency.  Has this mother not been getting paediatric support apart 
from the surgeons? How on earth has he been left to gain so slowly 
for so long?



Heather Welford Neil
NCT bfc, tutor, UK
-- 

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