Does anyone have any information on the use of human milk fortifier in older babies?  I searched the archives and did a google search and can only find reference to its use in preterm infants.

I posted a week or so ago about a 7.5 month old baby who has dropped from 30th to 5th percentile.  He is gaining 2-3 oz per week and is otherwise healthy, happy and meeting milestones.  The pediatrician believes that weight gain should be about 1oz per day and said baby is not gaining enough.  She sent the mom home with human milk fortifier  and has threatened hospitalization if the baby does not put on more weight.  The mom is very reluctant to use the fortifier and feels baby is healthy.  I gave the mom references to give the pediatrician re: weight gain in breastfed babies.  We talked about other ways to increase babies intake (breast compression, offering breast instead of pacifier, co-sleeping, experssing after nursing to get hindmilk and using the "cream" in babies cereal).  The baby is in daycare for 8-9 hours per day and takes one 6oz bottle  and 2 3-4 oz bottles of breastmilk.  In addition, he has cereal or other solid foods twice per day.  The mom is of very slight build and says that she was "thin" as a baby too.  I did encourage her to seek a second medical opinion on the fortifier and weight gain issue.  I did not advise her for or against the fortifier but told her I would seek more information.

Thanks,
Mellanie Sheppard IBCLC hopeful 2004
Arlington, TX USA

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