Abstract
Breastfeeding the extremely low birth weight (ELBW) infant with complex medical problems presents many challenges. This case study focuses on a 24-week ELBW infant whose mother was committed to breastfeeding. The mother was supported by the Neonatal Nutrition Lactation Team composed of the neonatal nutritionist and the lactation specialist, who collaborated to optimize the breastfeeding experience while meeting the nutritional needs of this high risk infant. Numerous medical setbacks required changes in the infant's nutritional management. Creamatocrits were used to assess breastmilk and a variety of artificial infant feeding products were added as supplements. Management of the infant's complex nutritional needs while maximizing the human milk provided requires commitment from the mother and all members of the health care team.