I have a question about this topic also. Does anyone know of any research about what is concerned to be "normal" weight gain for breastfed late preterm infants? Also, if there is any research about premies and normal weight gain when mothers are on methadone.

My theory on late preterm babies is that breastmilk is not designed to rapidly increase muscle mass and fat stores at first, but instead helps with lung maturity, immune protection and brain growth and then begins building fat stores later. Any research to back that up? 

Also, any info on late preterm weight gain when mother is on methadone? I once had a patient that was stable on methadone treatment for 2 years, exclusively pumping for 36 week infant. Day 1 - 5# 1 oz, lowest weight 4# 13 oz at day 4, at day 9 was 5# 0 oz, and MD wanted formula supplementation due to slow growth. Infant was overall stable and withdrawal symptoms lessening, and I was happy with rate of growth and improvement in infant. If anyone can point me to any research about normal weight gain rates in late premies, and/or infants of mothers on methadone I would appreciate it.

In the hospital, it seems that we have some contributing factors for high rates of formula supplementation in these babies:
1. Staff are used to rapid weight gain with formula
2. Staff feels that rapid weight gain is a sign of improved health
3. Rapid weight gain equals early discharges and thereby less work for staff

My theories are meaningless to staff though without research to back it up. Any info would be appreciated. I have an opportunity to talk to some of the MDs soon.

Thank you very much,

Tricia Shamblin, RN, IBCLC


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