Regarding the growth of one year old with Down Syndrome and heart
surgery.  Has she plotted his growth on a Down Syndrome growth chart?
 Is his rate of growth within normal limits? Could he be supplemented
with something thinner?  Have you thought about using one of the
handy-dandy new scales to weigh him and ascertain breastmilk intake?
Is this really a problem?- a 15 lb one year old whose had heart
surgery sounds pretty good.  Has mother tried massage before or
during breastfeeding to increase fat content in milk?  Has she
thought about expressing or pumping after feeding to collect more
hindmilk and using a supplementer to add this during a feeding?
Surely there is a solution that will allow mother to maximaze
breastfeeding and meet her baby's needs.

Cathy Liles, IBCLC
College Station, TX