> checking with r. lawrence... mom's diet can be manipulated to increase the
>fats... an increase in polyunsaturated fats in teh diet incresed the levels
>of linoleate in the milk to twice the previous levels.... p. 283-286I
Here I am on vacation (short) in San Diego, with no Ruth Lawrence or other
texts around, and I shouldn't be thinking about lactation, but...
My understanding is that one does not change the amount of fats, ("increase
the fats"), but one changes the composition (type) of fat through changes
in maternal diet. An increase of one fatty acid could be expected to occur
concurrently with a decrease in another.
Milk fat could be more effectively increased through mechanical means (i.e.
longer feedings, massage, breast compression, expressing foremilk) than by
changes in maternal diet.
>What would you suggest to "fatten up" a very healthy 8-week-old
>baby...Mom has increased her own fat consumption and has pumped after
>feeding and
>given the milk but things aren't getting better in the weight gain....I've
>read of giving 1 >T. of olive oil or other veg. oil, and I remember
>someone mentioning putting butter on nipples....
>There is a history of serious allergies in the family, but as the baby is 8
>weeks would butter still be a concern?
Cow milkfat is stripped out of infant formula because of its low
digestibility and interference with calcium absorption. Putting a smear on
nipples probably would neither be a big problem nor a therapeutic benefit,
because of low amounts involved. With a family history of atopic disease,
some other alternative would be better.
>If mom uses some oil, is there one that would be preferred? Flax seed?
>Cold-pressed almond or canola?
I had this same problem recently, and I didn't come up with a very good
solution. My patient's volume as well as fat and carbohydrate composition
were low, and we decided to supplement with condensed infant formula for a
short period of time. The problem with this was that low volume means low
fluid, so one doesn't want to add too much renal solute load and dehydrate
the baby. Our method was to have her add the unreconstituted liquid
formula to her expressed breastmilk for some feedings, and feed from the
breast ad libitum the rest of the time. This is not without risk, but
seemed the least risky way to proceed under the circumstances. We kept in
close contact with her during this period. Once the baby started gaining
weight well, the condensed infant formula was discontinued.
As far as fats, I found that Microlipid is safflower oil (please let my
memory be accurate here) with a little lecithin and other minor
ingredients. Its production has been discontinued, according to the
manufacturer (whom I contacted by phone), although we are still using it in
our hospital. For a healthy baby with no gastrointestinal issues
interfering with digestion, I believe regular (non-emulsified) safflower
oil would likely be an appropriate substitute. However, I would much,
much rather that the extra weight came from breastmilk, as adding fat to a
diet decreases the nutritional density of the diet. In other words,
breastmilk is such a rich and complex mixture of nutrients, and if one
simply adds fat, the ratio of vitamins, minerals, bioactive components,
etc., to calories falls. Fat is important in infant nutrition, but it's
not the only important component, and the best type of fat for infant
development is human milkfat.
I would be nervous about flaxseed oil because of its volatile components
and nut oils because of the potential for allergenicity, although the most
allergenic, peanut oil, comes from a legume and not from a nut. I would
like to know more about relative allergenicity and risk of different oils.
If you are confident you've ruled out any possibility of low milk
volume/intake, then perhaps fat supplementation is appropriate. The baby's
physician may want to rule out a metabolic or endocrinologic problem in the
baby....
Arly (going to the beach)
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