Breastmilk fortifier is a cow milk based formula that is added to human 
milk for very preterm infants to support intrauterine growth rates, it 
contains extra protein, calcium, phosphorus. It would not really be so 
helpful for babies who are failure to thrive because they don't have the 
same metabolic needs as very low birth weight infants.

A baby who vomits constantly could have a very severe case of reflux, a 
gi motility problem secondary to a mitochondrial disorder or partial 
blockage, or a metabolic disorder. I'm sure there are many other 
possibilities as well. Poor baby.

Sometimes vomiting babies do better if they feed at the breast rather 
than taking their ebm by bottle, especially if they can feed in more 
upright or semiprone/diagonal positions. Why is this baby not 
breastfeeding? Being unable to feed normally (breastfeed) is another red 
flag that all is not well with this little one.

Catherine Watson Genna, BS, IBCLC  NYC

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