Permission to post:  I am working with a 3 month old baby who recently had surgery due to biliary atresia. Baby was just  diagnosed with Failure- to- Thrive. Baby breastfeeds beautifully, and drinks about 3 ½  oz on the breast per pre/post feed weights. Her milk supply is fine.  It looks like the poor weight gain is due to the increased caloric expenditure and/or poor absorption from the biliary atresia. The MD already told them to expect this issue. The MD has recommended that the mom add 1 tsp of Progestimil to 2 ½ oz of expressed breast milk, 4 times per day. Baby refuses all expressed breast milk that has any Progestimil added to it.  As the family doesn't want to feed baby any formula, I suggested that she ask her MD if she could feed 4 oz. of pumped milk instead  of what he recommended. He  said it was ok to try that, but he really wants baby to have some formula. Baby still didn't gain weight with the 4 bottles of pumped milk, each with 4 oz, as well as breastfeeding very frequently on demand. Does anyone have any suggestions as to how to increase the caloric intake for a baby with biliary atresia   without using formula?

Thank you,

Susie McCulloch  IBCLC

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