I rec'd a phone call from a dad of a 2 1/2 mo old, down syndrome, p/s
cardiac defect.  This dad states infant is finally at the breast, but
tires very easily and parents were supplementing with fortified EBM using
an sns.  Dad just discovered fortifiers are ABM based and parents want to
add extra calories by mom pumping (as she already is) and skimming the
fat off the top to use in the sns.  Infant only feeds for short time.
Takes 2 oz of supplement while at the breast approx. 10 mins., one side.
Physician wants infant to receive 28 cal/oz supplement. Parents have
actually been using the skimmed fat for the past few days and infant has
gained 1/2 oz/day.  They have a scale at home and can do daily wts.  Mom
is thrilled infant is gaining, breastfeeding and using sns well at this
point.  Parents want to stop Human Milk Fortifiers (hmf) and use the
skimmed fat, physician wants hmf, can calibrate cal/oz.  Dad says infant
gaining ok why can't they do it their way.  I said I would get as much
information as possible.  I am going to search the archives.  I am
reading '98 edition of Breastfeeding and Human Lactation, but wanted to
know if anyone has ever done this and had success.  I will contact Dad on
Monday with information and hopefully this couple will be armed with
enough information to convince MD to at least try it and as long as baby
is gaining wt and doing well con't with same.
Dad wants to know if they are harming their baby.  They don't want hmf or
ABM to be used if at all possible.  Please reply privately or on lactnet.
 What ever is easier for you.  Tried to make this as short as possible.
TIA.
Darlene Breed BS, RN, IBCLC
Coordinator, Milk Bank/Breastfeeding Center
Worcester, MA (USA)

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