Someone had mentioned a while back that in Europe they increase volume, not fortification and that made sense to me.  Here in US breastmilk isn't seen as perfect, but as something that needs to be meddled with (ie:Fortification).

A mom called me about her diminishing pumped milk supply at 3 months.  She had been told on leaving hospital with her  38 weeks premie that she could nurse 4 times a day and bottle feed fortified breast milk or formula the other 4 x a day.  At 3 mo baby weighs 9 + lbs (10 weeks premature at 3 lbs 8 oz) with this regime but mom's supply is tanking. She had been pumping 6-8 oz each time, now dribbles :-(

My advice was to nurse baby every time she cued hungry and top up with what ever she can pump or formula.  Then gradually decrease amount she tops up with.  Keep pumping after feeds for stimulation.

I was really appalled that she was told to nurse 4 x a day and not told to gradually increase breastfeeding  and decrease supplements.

A Baby Friendly NICU program really needs to be developed and spread around the country (US!)  Pat in SNJ
 

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