Hello to all -

I am working with a mother who has a baby with Down Syndrome.  Baby is not
feeding directly from the breast but we are working on it.  The problem is
that the baby is not growing well in spite of adequate milk intake.  Baby is
just under 8# and we are at birth weight at 2 weeks.  Baby takes about 19 -
26-oz/24h using a Haberman feeder, but this is really pushing him to drink.
No cardiac problems but we seem to be having a problem getting him to grow.

Mom's supply is well ahead of baby and I was mulling over an idea to
increase caloric content of the milk.  Dr. Wight has said in the past that
the protein is very important for growth so I am not thrilled with just
skimming and using more fat because the protein is in the skim.  My thought
(which I would like you all to shoot holes in) is to separate the milk.
Then use low heat to evaporate the some of the water from the skim portion
thereby reducing the volume while keeping the protein content and adding it
back to the cream portion.  I am thinking this should be fed only a few
times per day so that baby gets fresh milk for the antibodies most of the
time.

Any feedback on the scheme?  Mom does not want to use HMF (Human Milk
Fortifier) or any formula.

Linda Pohl, IBCLC
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