Hi Ann,

This does not have to be complicated. If the baby is not gaining as well as
anticipated, mom can pump or express in between feedings, let the milk sit
in the fridge until the cream rises to the top, take off the cream and a
little of the milk underneath and feed to baby in addition to breastfeeding
with an eye dropper.  

These babies don't always have weight gain problems, so I would not jump in
with intervention unless it is really necessary. An SNS could also be used
with feedings to increase intake/calories, but one needs to be careful not
to overwhelm a possibly low tone baby with more milk than she can handle at
one time. 

Warmly,
Sharon Knorr BSMT, IBCLC

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