Carolyn writes:

>I have occasionally tested milk for fat content.
>
>Before you all jump in and shout at me,

Ha! I think  I'm the one you mean, Carolyn : )  I wouldn't jump or shout
though, believe me : )



Well,it can be useful on rare
>occasions when everything else, including illness in baby, have been
>looked at.

I am sure you are right - illness in the baby and 'everything else',
including freq. and effectiveness of  feeding has to come before this is
tried.  In the case originally posed, this did not seem to be the case.


>There is a specific way of doing it - over 24 hours - which gives total
>fat which baby is getting.

I would love to know more.  Is every feed sampled? If so, how do you know
whether you are reflecting accurately what happens when the next let-down
comes? Or are the babies taken off the breast so the mother just expresses?

I know that in cases where the mother of a VLBW baby is pumping,  the fat
content can be altered by pumping longer, and this is used to
'artificially'  increase the fat content of the EBM the baby is getting by
tube.

>I do it about once a year, and only once has there been a problem.
>In this instance the total fat content was 10g/litre - very low.
>We managed, over a period of 3 weeks to increase it to normal levels

By getting her to feed more often?

>and
>the baby then thrived on breastfeeding until Mum weaned at 18 months of
>age. Baby was about 3 months old when we tested the milk.
>

>I feel that we are dismissing out of hand a test which is available to
>us which may be useful on a few occasions. No-one is suggesting that
>this should be a routine with all problems, let us keep an open mind
>please!

I was not dismissing it out of hand. My questions were a genuine  - if we
don't know what we are looking for, if we can't test accurately, then why
test at all?  Instead, why not move straight to more freq. and more
effective feeding?

If you're saying you *do* know what you're looking for, you *can* test
accurately, and you always rule out illness and ineffective feeding first,
then my mind is wide open indeed : )

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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