Have permission to post and need some info. I'm currently working (as a LLLL
-- not LC hat) with a mother of twins (MOT) who'd previously BF two term
singletons well into toddlerhood. Her B/G twins were born Aug 31 at 34 weeks
(due date of Oct 13); the little guy weight 3 lb, 14 oz (1769 g) and the
little gal was 3 lb, 7 oz (1560 g) at birth. Within a day or two they were
EBM-fed and have gradually moved to almost full BF with occasional EBM. Did
a "drive-by" visit  weighed them last week (nude weights) and little guy was
9 lb 9 oz (4355 g) and little gal 8 lb, 10 oz (3901 g). Weights seemed to
reassure mom, who has been worried about production, and time to do extra
pumping is obviously at a minimum with frequently BFing twins and 2 other
young children. (Has tried some "power pumping" via keeping pump set up and
doing a few minutes here/there as able. Observed some infant issues that may
be contributing and discussed how she might work on these.)
Now for questions set-up -- Babies saw pedi and were weighed again within a
few days of the at home weight check with me, and mom said the pedi seemed
pleased with their progress and weights. However, the pedi suggested
introducing some solid food and per mom  more for her/mom's sake than
babies. She was also told to feed solids prior to BF vs. BF first and that
this wouldn't hurt production. She called me because the info didn't sound
quite right to her -- both introducing solids at this point and the offering
of the solids first prior to BF. I'm aware of the effect of offering solids
before BF first and we discussed this, but I asked if I could take the other
questions to you.

These babies are now 4.5 months chronologically (so still on the young side
for solids) from birthdate but only 3 months when age is adjusted for full
term. And it again hit me that there doesn't seem to be much out there re:
whether recommendations for the introduction of complementary foods "fit"
preterm and late preterm infants. Does gut closure/maturation occur earlier
for preterms due to early exposure to outside environment? Does an infant's
ability to metabolize the nutrients in complementary foods follow as for
chronological age or is it related to maturation vis-a-vis full term
(adjusted) age?

Have tried a lit search, checked BF preterm resources, etc. but these seem
limited to use of EBM in early weeks and transition to direct BF. I can't
really find anything, much less evidence-based info, addressing whether
there are differences for nurslings who are "former" premies re:
introduction of and gradual adding of complementary foods.

Any help, resource/ref info anyone could offer would be most welcome!
Thanks...

-- 
Karen G
513-325-2550
www.karengromada.com/

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