Hi Riva,

It seems that we are speculating all the time, and never dealing with facts. I am intrigued by this story, especially knowing that there can be quite a variation in caloric value of human milk. I am also aware of conditions such as thyroid dysfunction and anemia that can result in less fat in the milk, which translates to fewer calories. While this is rare, it is not unheard of. Whether or not the mother has risk factors, how about getting a creamatocrit done on her expressed milk, preferably a few samples? That would settle the major question. 



In the meantime, you might consider suggesting she use lots of massage and compression to maximize the cream content of her expressed milk.



~Lisa Marasco



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