>PTP. 
>M of a 6 m old girl is being asked by MD to increase wt of baby.Baby 
>has some developmental delays and is significantly below the 2% line 
>on the WHO growth chart. M has asked me if there is a way to 
>increase the fat content of her milk.   M has been doing a modified 
>form of block feeding from the early days.  My first visit with the 
>dyad at 2 weeks, baby had bright green stools, and when she 
>implemented a block of 2 hours of staying on the same side, the 
>stools changed and stayed yellow.  She has tried to go back to BF on 
>both sides per feed a couple of times, but the green stools return. 
>M reports baby wakes every 2 - 3 hours at night to BF.


There's nothing necessarily wrong with green stools.

Weight gain would be a better indication of whether the block feeding 
is making a difference.

Generally, block feeding *reduces* supply and volume of intake, and 
often very effectively. Can be a useful technique when mothers and 
babies are drowning in breastmilk :)

It would not normally be recommended for a baby with a slow weight 
gain - but a block of two hours is prob ok, as this would still allow 
for frequent feeding, which is what drives supply up and weight gain 
up.

Main way to increase calorie intake (and therefore weight gain) is to 
feed more often, on both breasts, 'switch nursing' if needed, plus 
breast compressions to keep the baby interested.  Waking 2-3 hourly 
for feeds at night needs to be unpicked - if this is between (say)  7 
pm and 7 am, it's not sufficient.

There is no way to increase the fat content of the milk via the mother's diet.

The baby is old enough for solid food - easiest way to increase her 
intake of calories would be to give her calorie-dense foods - banana 
and/or avocado are what are offered here in the UK, plus cereals.

Heather Welford Neil
NCT bfc, tutor, UK

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