Paula- talk to your lab supervisor- it is very, very easy to do a
crematocrit ( P Meier has all her mothers doing this procedure to prevent
tying up the nurses)
To do a crematocrit,Dr. Meiers uses the following technique:
1)  Mother pumps fresh milk into container and shakes well for 5 minutes
2) from this sample, pour about 1/2 cc into a sample cup
3) Mix sample by shaking again for 5 minutes
4) Fill 2 non-heperinized microhematocrit capillary tubes with milk
5) Seal capillary tubes at one end with Critoseal
6) Place tubes with sealed end to the outside of the centerfuge,in a
counter balenced position
7) Screw lid in place
8) Close top of centerfuge
9) Set timer for 5 minutes
10) When spinning stopps, remove tubes from centrifuge
11) place tubes on hematocrit reader with Critoseal end at the top
12) Place the intersection of sealant and milk at the cross-point of the
curved line
13) Rotate upper disk so that the bottom of the curved line intersects
BOTTOM point of milk in the capillary tube
14) Set lower percentage disc at 100%
15) Rotate percentage disc until curve line intersects the cream layer of
milk
16) Subtract this percentage ( usually 85-95%) from 100%. The result is the
CREMATOCRIT ( usually 5-15%)
(adapted by Rush Mothers Milk Club from : Lucas et al (1978) Creamatocrit:
Simple clinical technique for estimating fat concentration and energy value
of human milk. British Med J 1;1018-1020  )
I also thinks is kinda the same technizue dairy farmers use also ( please
no flames)
To feed higher crit milk , mothers would of course begin pumping then stop
and perform a crit to view that level of crematocrit.  So if your trying
to  convince her MD I'd suggest maybe sending samples from 3-4 stages of
pumping ( beginning, 2 minutes later, 5 minutes later and 7-10 min) to get
a range. This might give you the numbers you need to support just whne the
mom could nurse baby at breast to promote caloric intake or to use EBM from
different points to boost the calorie count.
Hope this helps,
Lisa Jones RN IBCLC
Madigan Army Medical Center
Taking joy in our new babies and mourning our national losses- God Bless

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