Increasing fat in breastmilk? X-POSTED in Breastfeeding Challenges

[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?

[Bokonon]

20g isn't much though - could it have been loss from water weight?  How did they determine that he's not receiving enough protein?  

(((hugs))) mama.  

[MadelinesMama]

I guess to them 20 grams is a lot.  I was just told that he needed some extra protein to get him over this hump of not gaining weight two days in a row. 

[Ratchet]

This will work but I don't know if it will make the NICU happy-- you can pump, discard the first milk, then save and feed the rest- in terms of how much to discard, etc I don't know and it would depend on your own milk. Not many NICUs have the ability to test that in-house. You could just do it however seemed right, not tell them and just see what his weight does.  That being said they may still supplement for increased calcium, phos, iron etc needs.  My 27-weeker always gained weight beautifully but stayed on fortified breastmilk (initially with human milk fortifier and now that she's home, on neosure-- she is getting almost all breastmilk in a bottle b/c she still hasn't figured out breastfeeding).  On one hand I don't like the junk that is in that (corn syrup, etc) but I also feel like she deserves to achieve her growth potential, and it was with this fortification that she was able to return to and stay at her birth weight percentile (50th percentile) while quite often preemies end up losing some ground there.  What are the long term benefits of achieving your growth potential vs the harms of fortification?  I don't know.  She did get straight breastmilk for her first few weeks (initially just for oral care while she was on TPN, and then as they s-l-o-w-l-y increased her to full feeds), so at least I wasn't worrying as much with gut flora and gut closure etc. 

[MadelinesMama]

Ratchet,

One of the neonatologists actually suggested pumping off the foremilk and feeding him just the hindmilk (that they then fortify with HMF).  I did that all day yesterday so hopefully he had a weight gain when they do his weight today.  Thank you for the response!