Wendy Brodribb writes: "The mother really wants to continue to breastfeed this baby as she feels her supply is not the problem, and changing to formula in the past has not helped her babies. " Just two things came to mind. She might benefit from a one of the specialized scales designed to measure breast milk intake during breastfeedings through pre and post breastfeeding weights. That way it could be determined the exact volume of milk the baby is getting. If the volume is low, measures could be taken to improve that such as using a supplementer at the breast. The scale would continue to provide accurate and valuable information about the baby's actual intake. If the volume of milk taken from the breast is appropriate then the baby needs to be checked further for problems of metabolism and supplementation might be fruitless as it was with her siblings. Also, might this baby benefit from mom pumping off some of the fore milk so the baby has the higher fat hind milk for feedings. Idealy it would be great to have her do a creamatocrit as described and used by Paula Meier in her NICU (sorry I don't have the reference right now, rushing out to see patients) to determine the exact fat content of mom's milk and at what point into the pumping the fat content reaches the desired level to increase the caloric content to an appropriate level for this baby. Kathy Kuhn RN, BSN, IBCLC ParentsPlace.com LC private practice LC Eastern PA USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html