Tricia My experience, as opposed to research, is that the paediatricians of the prem babies I used to work with liked a gain of roughly 20g/day for the smaller pre-terms - <1500g. But if born over that weight they liked a gain of 30g/day (1 oz a day). The UK charts, based on the WHO charts, which _are_ based on research :-) confirm that a gain of at least this much is expected (ie seen as normal) for late pre-terms. See UK-WHO Growth chart for boys, includes pre-term weights <http://www.rcpch.ac.uk/system/files/protected/page/A5%20Boys%20UKWHO.pdf>http://www.rcpch.ac.uk/system/files/protected/page/A5%20Boys%20UKWHO.pdf UK-WHO Growth chart for girls, includes pre-term weights <http://www.rcpch.ac.uk/system/files/protected/page/A5%20Girls%20UKWHO.pdf>http://www.rcpch.ac.uk/system/files/protected/page/A5%20Girls%20UKWHO.pdf If a premie is stable and healthy, but gaining less than this, then the baby's breastmilk intake needs to be increased - ie from 150-180ml/kg/day up to as much as 300ml/kg/day. The paeds I worked with would increase the EBM in 30ml/day increments, ie from 180ml/kg/day to 210/ml/kg/day, then to 240ml/kg/day etc. It is not necessary to give formula or other milk supplements or fortifiers to achieve a better weight gain, nor to play about with the fat/calorie content of the EBM - simply feed _more_ ordinary breastmilk. So easy, so natural, so normal, so nutritionally suited to the pre-term infant! Pamela Morrison IBCLC Rustington, England ----------------------------------------------------- Date: Sat, 26 Apr 2014 12:15:14 -0700 From: Tricia Shamblin <[log in to unmask]> Subject: premie weight gain issues I have a question about this topic also. Does anyone know of any research about what is concerned to be "normal" weight gain for breastfed late preterm infants? Also, if there is any research about premies and normal weight gain when mothers are on methadone. My theory on late preterm babies is that breastmilk is not designed to rapidly increase muscle mass and fat stores at first, but instead helps with lung maturity, immune protection and brain growth and then begins building fat stores later. Any research to back that up? Also, any info on late preterm weight gain when mother is on methadone? I once had a patient that was stable on methadone treatment for 2 years, exclusively pumping for 36 week infant. Day 1 - 5# 1 oz, lowest weight 4# 13 oz at day 4, at day 9 was 5# 0 oz, and MD wanted formula supplementation due to slow growth. Infant was overall stable and withdrawal symptoms lessening, and I was happy with rate of growth and improvement in infant. If anyone can point me to any research about normal weight gain rates in late premies, and/or infants of mothers on methadone I would appreciate it. In the hospital, it seems that we have some contributing factors for high rates of formula supplementation in these babies: 1. Staff are used to rapid weight gain with formula 2. Staff feels that rapid weight gain is a sign of improved health 3. Rapid weight gain equals early discharges and thereby less work for staff My theories are meaningless to staff though without research to back it up. Any info would be appreciated. I have an opportunity to talk to some of the MDs soon. Thank you very much, Tricia Shamblin, RN, IBCLC --- This email is free from viruses and malware because avast! Antivirus protection is active. http://www.avast.com *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome