Cystic fibrosis is another possible diagnosis to rule out.

One easy way we used to increase weight gain in a recent baby with Down
syndrome and cardiac problems was to have mum pump, let milk separate and
then draw up the cream with an oral syringe.  Baby breastfed well and would
not take a bottle but tolerated "doses" of cream by syringe.  Baby plumped
up well and had successful heart surgery last week. Mum would store the
remaining milk at times but ran out of room in the freezer. Since baby is
happily breastfeeding and mum plans to continue into toddlerhood she will
have little need for stored milk.  Now that surgery is done we expect baby
to gain well on her own.

This method was easy for mum and baby.  Pumping and switching bottles twice
to get the hind-hindmilk like Paula Meier suggests would be more work but
might be needed if baby is not gaining.

The Lactation Consultant's Series module available from LLLI on slow
gaining babies is an excellent resources. Very methodical and helpful.

Janet Vandenberg RN, BScN, IBCLC, Public Health Nurse
Ontario, Canada

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