Paula- talk to your lab supervisor- it is very, very easy to do a crematocrit ( P Meier has all her mothers doing this procedure to prevent tying up the nurses) To do a crematocrit,Dr. Meiers uses the following technique: 1) Mother pumps fresh milk into container and shakes well for 5 minutes 2) from this sample, pour about 1/2 cc into a sample cup 3) Mix sample by shaking again for 5 minutes 4) Fill 2 non-heperinized microhematocrit capillary tubes with milk 5) Seal capillary tubes at one end with Critoseal 6) Place tubes with sealed end to the outside of the centerfuge,in a counter balenced position 7) Screw lid in place 8) Close top of centerfuge 9) Set timer for 5 minutes 10) When spinning stopps, remove tubes from centrifuge 11) place tubes on hematocrit reader with Critoseal end at the top 12) Place the intersection of sealant and milk at the cross-point of the curved line 13) Rotate upper disk so that the bottom of the curved line intersects BOTTOM point of milk in the capillary tube 14) Set lower percentage disc at 100% 15) Rotate percentage disc until curve line intersects the cream layer of milk 16) Subtract this percentage ( usually 85-95%) from 100%. The result is the CREMATOCRIT ( usually 5-15%) (adapted by Rush Mothers Milk Club from : Lucas et al (1978) Creamatocrit: Simple clinical technique for estimating fat concentration and energy value of human milk. British Med J 1;1018-1020 ) I also thinks is kinda the same technizue dairy farmers use also ( please no flames) To feed higher crit milk , mothers would of course begin pumping then stop and perform a crit to view that level of crematocrit. So if your trying to convince her MD I'd suggest maybe sending samples from 3-4 stages of pumping ( beginning, 2 minutes later, 5 minutes later and 7-10 min) to get a range. This might give you the numbers you need to support just whne the mom could nurse baby at breast to promote caloric intake or to use EBM from different points to boost the calorie count. Hope this helps, Lisa Jones RN IBCLC Madigan Army Medical Center Taking joy in our new babies and mourning our national losses- God Bless *********************************************** 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