Thanks to everyone who wrote to me a few weeks ago about Sophie--the baby with a congenital heart defect, cleft palate and Dandy Walker Cyst. Sophie is home now. She is taking EBM fortified with polycose and vegetable oil per bottle. It sounds like she hates it, she often vomits her feedings, but is still gaining weight. Mom is very anxious, is having a hard time feeling like a mom. She's also getting burned out on pumping. "All I do is feed her and pump, feed her and pump." It takes Sophie about an hour to eat, what with mixing up fortifier, meds, and the bottle. The mom was pumping about 8 oz. 6 times a day. She is now pumping 5 x a day 6-7oz, but gets uncomfortably full if she tries to pump less than that. I haven't mentioned cabbage-- I'm not sure adding another step to the routine would be wise. Any suggestions on decreasing her supply? I don't think it is the pumping that is the main problem right now, but it is where she focuses her frustrations. We are working on a plan for breastfeeding. I wrote that a couple of days ago. Sophies mom just called me and gave me an update--Sophie has stopped gaining weight, is still vomiting during feedings if they try to force her to eat. She won't open her mouth, pushes the bottle away. She also gags on a pacifier and seems to choke on her own saliva sometimes. The Neurosurgeon is going to do a shunt tomorrow (a tube that drains off spinal fluid from brain), but is not convinced that increased intracranial pressure is causing the vomiting. Sophie's mom wants to give her breast milk, but is still having to pump more than she wants to --she gets about 50 oz a day. Was starting to get plugged ducts. I told her to try cabbage. The other problem is that her insurance company has refused to pay for fortifier, which is going to cost $200/week. (Since she is not gaining weight, the docs want her back on 30 cal/oz. breast milk, which requires the fortifier.) Any suggestions? Please e-mail me privately and I will post later--I'm already behind reading my digests TIA Chris Lundberg RN, IBCLC Indianapolis