Hi Jan,

Some questions: 
Has the baby been steadily gaining? 
Is the doctor using WHO growth charts?
What is meant by "thickening?  
Does the thickening agent add calories?
How is mother's milk supply?

If mother's supply is good, perhaps a better way to add calories would be for her to:
* pump a bit off first then start the feeding so as to get to the higher fat milk more quickly.
* do breast massage and "kneading" before starting the feeding, which I have read/heard can help get a faster milk release and get more fat into the initial milk flow.
* do breast compressions while baby feeds, since he is technically just 2 weeks post original due date.  He may not be the most efficient feeder having had various feeding methods in the NICU - most them by tube or bottle - so a little "push" from the breast compressions may up the flow and keep him nursing more aggressively.

Interested to hear others' thoughts and ideas.

Cindy Garrison BS IBCLC

> 
> Date:    Mon, 18 May 2020 19:11:41 -0400
> From:    Jan Barson <[log in to unmask]>
> Subject: Thickening EBM
> 
> What is the current method for thickening EBM. This baby is 6 weeks prem now 2 monrhs old and being BF but the paediatricians are worried about the slow weight gain. He is fully BF/EBM and the mother has now been told to give thickened formula to top him up. He is a real chucker.  She now has access to donated EBM and would like to not use the formula. I only know of Karicare thickener, is there anything new, better, suggestions? Thanks all you wonderful clever helpful people.
> 
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