Increasing fat in breastmilk?

[MadelinesMama]

My preemie was receiving breastmilk (1 oz every 3 hours) and TPN until Tuesday.  They stopped the TPN and he lost 20 grams in 2 days.  At that point they informed me that he wasn't receiving enough fat and protein so they were going to start supplementing with a high protein formula for 2 of his feedings.  I am not thrilled about this at all, and I'm worried that they will try to increase the amount of formula he is receiving if he doesn't have the weight gain they expect.  Is there any way that I can increase the fat content of my breastmilk?  I've considered trying to skim the fat off the top after it separates and adding it to the milk that I'm taking into the NICU for him.  I am scared to increase the frequency of my pumping because I had a horrible oversupply with my daughter and it seems like I might be headed there this time as well.  Does anyone have any suggestions or experience with this?

[Thing1Thing2]

So sorry to hear about what you are going through. Hugs.

Have you tried eating more fats yourself. Healthy fats such as avocadoes and olives surely can't do any harm.

Hope this helps.

[sundaya]

I read about a mama basically pumping off the first portion of milk(you could freeze for later) and giving the last portion of milk pumped, which should be more hindmilk, and therefore more fat, to the baby. So for instance if you were needing one ounce and thought you might pump 2 ounce, saving the last one ounce pumped for the baby. Also, skimming the fat to add back in couldn't hurt, right? Good luck, and I hope your LO grows and thrives and can come home soon!

[MadelinesMama]

Bonnie,

I have read that increasing fats in your diet does not increase the amount in your breastmilk.  But with that being said I do already eat quite a bit of those healthy fats anyways.

Sundaya,

I was thinking about doing that, but I was going to just throw away the foremilk. I think I will give this a shot.  It seems easier than skimming the fat off other milk.

[Megan73]

You're right - increasing fat in your diet won't increase the fat in your BM. Here's a link from kellymom.com that explains it: http://kellymom.com/nutrition/milk/change-milkfat.html
The key thing is that the emptier the breast, the more fat in the milk. Could you pump more often or throw in some hand expression between pumping sessions?

[queencarr]

When I pumped for my preemie, increasing my fats did seem to increase those in my milk. I increased the nuts, olive oil, eggs and dairy fats ( cholesterol is supposed to be good for preemie brain development from what I read). I also took all my prenatals plus b complex, a,c and e, as well as choline and inositol and ate nutritional yeast as much as I could. He received 1/2 milk and 1/2 fortifier until he came home, both for the extra calories but also to extend my supply slightly (was standard at our nicu 13y ago unless specifically requested and medically ok'd). He gained 1-2 oz per day in hospital. When he came home, we went to straight breast milk (still pumped-it took 5 months to coordinate skills for nursing) and he gained at least 1 lb per week for probably the first 2 months, so faster on straight milk.

To get more of the fat himdmilk, I pumped long sessions-30-45 minutes; the droplets for the last 15-20 min were almost completely cream but came out very slow, like three "sucks" per drop. I preferred this to skimming for a couple of reasons. First, I needed everything I had in those early weeks. But I was also concerned about altering the natural nutritional balance of vitamins, proteins, sodium/potassium, etc. My reasoning, and that of my nicu nurse that was also an lc (very helpful to be trained in both!) was that hungry babies feed longer to get satisfied, and we wanted to mimic that process as much as possible. Imbalance of certain nutrients in preemies can cause it's own issues.

[MadelinesMama]

This morning the first thing the neonatologist brought up was that she would like me to pump off some of the foremilk then switch to a different bottle to pump the hindmilk into.  They are going to fortify the hindmilk and feed him that.  If he shows weight gain we can forget about the formula.  If not she will be fortifying it with a high calorie formula. This makes exclusively pumping even more of a production.  It's fine now, but I go back to work soon and that's going to complicate things since my breaks are short.

[Jean1971]

I will preface by saying I've never had a preemie. But I have nursed 4 babies. My initial thought is why aren't they feeding your baby more often rather than supplementing with formula? Every three hours seems way too long, imo. My newborn liked to nurse every 1 1/2 hours all day. I mean, their tummies are only the size of an egg four days after they are born when they are full term. I read that in an article on a website about breastfeeding. http://healthy-family.org/caryn/1442/10-nursing-lactation-tips-for-the-postpartum-mom Also, when the baby nurses directly from the breast they are much more efficient than your pump is at extracting the milk. I agree that a longer pumping session is a good idea to get more hind milk into the bottle. But the baby needs both the foremilk and hindmilk for nutritional reasons.

[MadelinesMama]

Well.. he's getting a very small amount of milk every 3 hours.  And even then he sometimes has some left in his tummy that's undigested.  I don't think they are as efficient at digesting as a full term baby.  He isn't able to breastfeed at this point.  He was born at 27 weeks and they don't generally have the ability to coordinate the suck, swallow AND breathe concept until closer to 34 weeks. I look forward to when that will happen and I can stop some of this crazy pumping.

[KateDavies45]

Originally Posted by MadelinesMama 

Bonnie,

I have read that increasing fats in your diet does not increase the amount in your breastmilk.  But with that being said I do already eat quite a bit of those healthy fats anyways.

Sundaya,

I was thinking about doing that, but I was going to just throw away the foremilk. I think I will give this a shot.  It seems easier than skimming the fat off other milk.

I was in the same situation with DD, and this was pretty much what I was doing for about a week. Also, for skimming the fat off milk already pumped if you store it in a tall, thin container and let it seperate for an hour or two in the fridge, it's pretty easy to see what part you need to skim off and to get most of the fat from that portion.

[AmyJeanneBee]

Originally Posted by KateDavies45 

I was in the same situation with DD, and this was pretty much what I was doing for about a week. Also, for skimming the fat off milk already pumped if you store it in a tall, thin container and let it seperate for an hour or two in the fridge, it's pretty easy to see what part you need to skim off and to get most of the fat from that portion.

Hi, I know this is an old thread but I just found it on a search for increasing breast milk. I was wondering KateDavies45, when you skimmed the fat off older milk and added it to fresh, did your baby gain weight well with that? He's still on fortifier (Neosure 22cal) and I'd like to get him off it but not compromise his weight gain. I have a bunch of frozen breast milk I'm willing to take the fat off of for his current bottles. We're still trying to get him to breastfeed of course but that is an ongoing process. Thanks!

[LilMomma83]

We're in a similar boat...I'd love to hear anyone's responses also... :-)

[MadelinesMama]

I guess I should update and say that pumping off the foremilk and then giving him just hindmilk worked for my son.  I was able to get the dr's to ditch the formula after a couple days and just give hindmilk (which they fortified).  He went on to gain consistently about an oz every single day.  After about a month of that we started doing half hindmilk bottles and half normal bottles until I eventually went back to normal pumping.

[LilMomma83]

Originally Posted by MadelinesMama 

I guess I should update and say that pumping off the foremilk and then giving him just hindmilk worked for my son.  I was able to get the dr's to ditch the formula after a couple days and just give hindmilk (which they fortified).  He went on to gain consistently about an oz every single day.  After about a month of that we started doing half hindmilk bottles and half normal bottles until I eventually went back to normal pumping.

Wow! I've been thinking of trying this...I think I will, we've been fortifying just regular pumped milk, and the most DD has gained was about 1/4 ounce per day.

[MadelinesMama]

It get's annoying after a while, but it did work really well for us.  We even had two weeks where he gained an entire pound in 6 days.  Good luck!

[LilMomma83]

Originally Posted by MadelinesMama 

It get's annoying after a while, but it did work really well for us.  We even had two weeks where he gained an entire pound in 6 days.  Good luck!

Wow..we aren't even at a pound in a month! I'm willing to try most anything...I just pumped and I went until the milk had almost stopped flowing (I alsways take a break then anyway to hand express, massage, etc) and I did the hand expression and the rest of the pumping into a seperate bottle...it did seem a lot thicker. So I had almost 6oz of white-blue milk and around 1.25oz of white-cream milk... I hope this will help some! I've been maintaining an "over" supply to help my DD latch/suck better, but, I've been concerned she is getting too much formilk, so hopefulyl this will help.

[MadelinesMama]

Good luck!!  Let us know how it turns out for you.

[LilMomma83]

Originally Posted by MadelinesMama 

Good luck!!  Let us know how it turns out for you.

Thanks!!!