Been there, done that!  When supplemented with ABM, my baby had horrible
reflux.  When switched to supplementing with high-fat hind milk in the SNS,
she did much better, even gained weight better!  No, they are not harming
their baby, they're probably helping.  IQ will probably increase, too, as a
result of the extra DHA and AA in the fat fraction of human milk that
aren't in the artificial stuff!  If it ain't broke (what they're doing
now), don't "fix" it by making them use artificial stuff.  Adequate caloric
intake is defined by baby gaining adequate weight, not by some arbitrary
number.  For babies with heart defects, the magic number differs from one
baby to the next anyway.

Becky Saenz, MD
Assistant Professor of Family Medicine
Univ. of MS Medical Center