A mom came in today who is still breastfeeding her 8 month old baby who
has Down's Syndrome.  The child also has had cardiac surgery in the past
months,  and is now hospitalized with pneumonia and has had to have a
tracheotomy.   He is also undergoing tests for reflux.  This is the
mom's 5th breastfed child, and she is understandably "stressed" at this
recent hospitalization.  The child had been doing pretty well  up until
a few weeks ago when he did not seem to be gaining weight  - he was put
on some additional formula with cereal added to supplement the
breastfeeding.  According to the mother things started going "wrong"
about that time - not sure if this is where the respiratory problems
started or it was all just a concidence as to the time the child got
pneumonia.  Anyway, the mom is looking for ways to help the child start
gaining again - she is asking about human milk fortifier.  I know of its
use in the NICU, but is this ever suggested for the older child?  I
suggested that the mom pump prior to feeding to stimulate the let down
so he gets more hindmilk.  Any other suggestions?

Thanks,  Evelyn Landry, RN, IBCLC, LLLLeader
Lafayette, LA

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