My name is Amanda Copeland and I am an IBCLC from Griffin Georgia.  I work for
Ga. District IV Health Services and today a colleague from Habersham county
(very North GA) called me about a problem she is having with a BF couple.
This little girl was born about 8 weeks premature, is now 2 months old.  Mom
was exclusively breastfeeding, but baby's weight went from 5# 11oz at birth to
4# 11oz when MD recommended she supplement with ABM after each feeding.  Baby
is gaining weight now; breastfeeds very well but always "requests" a
supplemental feeding after BF.  Mom wants to return to exclusive breastfeeding
and my colleague has tried many things to get baby to be satisfied with
breastmilk.  Mom has been pumping to increase milk supply, lets the baby stay
at the breast as long as she wants( sometimes up to 2 1/2 hours!); she uses
alternate hand massage to increase amount of fat in milk for baby; she has
increased her intake from 3 meals to 6 meals a day(mom is slender but healthy)
all in an effort to return to exclusive breastfeeding.  Even after all this
and a good 2 hours at the breast, baby is fussy, cries and wants to stay on
the breast the whole time unless mom gives a bottle with formula in it.  Then
baby will sleep for a couple of hours.  She will not do that if she does not
get a bottle.  Mom stated that when she pumps AFTER feeds, the milk still
looks thin and when it separates, only a very thin layer of fat comes to the
top.  My colleague wondered if the actual breastmilk does not have enough fat
in it to satisfy the baby and if she could have it tested.

I am getting all this info second hand, but I offered to post this on LACTNET
and see what kind of response we get that could help this BF couple.  Mom has
stated that her first baby was supplemented throughout the 5 months of BF and
she finally quit due to frustration in not being able to totally BF.  Mom is
very motivated and really wants to feed her baby herself.  My questions:  is
this truly a problem with the content of the breastmilk and should it be
tested?  and if so, where should she go to have it tested?  The LC that is
working with this couple has observed feeding, checked for tight frenulum and
mom does feel full before feedings and flatter after feedings.  Mom  has no
soreness and pumps good quantities, but states that baby isn't satisfied with
supplementation of br. milk, only formula.  I suggested a SNS until we could
resolve the problem to avoid bottles but mom was not "comfortable" with it.

Any help is greatly appreciated.

Amanda Copeland, IBCLC
from Griffin, GA where it is unseasonable warm and feels like Easter more than
Christmas! I LOVE IT!