Jennifer-  I am so sorry for this mom.  What an inappropriate comment, "long 
out-lived her usefulness"
pumping milk for this baby.  Terrible.

I would question whether it is appropriate to expect him to be above the 3rd 
percentile.  I do not know the extent of his brain injury, but it sounds 
pretty severe.  If his head is at the 3rd percentile because of anoxic 
injury, then you cannot expect to make it grow larger with more calories! 
And if weight is proportional to height then I don't see the advantage to 
putting on weight for the sake of putting on weight.

S0---I would support continued breastmilk, especially throught the winter to 
help him avoid infection.  And enough solids to get him the additional 
minerals he needs (mostly iron and zinc).

You are a good friend, AND a good doctor!

Kathy Leeper, MD, IBCLC
Lincoln, NE 

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