Laura says,
 
The pediatrician wants the baby to gain faster. We actually think she  may 
have finally started to but the mom wants references to give to the  
pediatrician of why it isn't best practice to add PIF to breastmilk to increase  
calories in case the weight gain is still low. The mom really likes the pedi 
and  wants to keep a good relationship but is listening to me about solute 
load and  the other dangers of PIF. The pedi has shown herself to be open to  
information.
**************************************************************************
 
Two comments --  what of the dangers of destroying elements of breastmilk 
(like lactoferrin) by  adding iron fortified formula directly to the  
breastmilk?
 
Second -- if the  baby is a slow gainer, but is meeting developmental 
milestones -- if the milk is  available, but she doesn't want it -- shouldn't we 
listen to the baby?  I'd  be a lot more concerned if she was FTT, but 3 to 4 
ounces a week is slow, and  slow can be OK.  
 
Jan Barger, RN,  MA, IBCLC, FILCA
Lactation  Education Consultants


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