>I just finished talking to a mom of a 5 week old who has not reached her
>birth weight!(off by 3 ounces now)  The peds are wonderful and just started
>to encourage to supplement last week - even then they used EBM!! After 4
>days of supplementing feedings with a total of 6 ounces of EBM/24 hours the
>baby did not even gain an ounce!  Now we are supplementing with formula at
>16-20 ounces in 24 hours. Needless to say, the mother is most discouraged.
>Anyway, the peds (and myself) are interested to know if there is anywhere
>in the Maryland area where we could send milk off to get an analysis done,
>(in particular, a fat analysis).  Would a regular lab be able to deal with
>this?  Thanks for any help.

Carol, I would *very* surprised if there is actually something
'wrong' with the composition of the breastmilk (barring nutritional
abnormalities in mum, such as pernicious anaemia, unsupplemented
strict vegan, etc and even then this problem of no weight gain would
be unlikely to show up so early).

I would look first at baby's output, to judge exactly *how much* is
going through. If not sufficient, then it is a supply problem, not a
milk composition problem. If there seems to be normal to large
quantities of milk going into baby (evidenced by lots of wet and
dirty nappies), then lack of weight gain is most likely to be caused
by inefficient utilisation of that food. Is baby unsettled? Symptoms
of secondary lactose intolerance from an irritated gut? Of course,
medical reasons for malabsorption or extra-high needs for calories
should also be ruled out. In other words, I would think
'baby-problem' before 'mother's milk problem'.

Have these sorts of things been considered? It will be interesting to
see what sort of gains baby shows on formula. From the above, it
sounds as though it is just *assumed* that formula will put weight on
when breastmilk and EBM could not. Breastmilk is assumed to be guilty
until proven innocent. Personally, I am not comfortable with that
sort of assumption.
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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