24 Calorie Mix

When we came home from the NICU they gave us instructions on making up a 24 calorie mother's milk recipe where we added Enfamil Enfacare to Breast Milk.

Does anyone else have to this? Are you ever allowed to stop? I must admit I don't quite see the point. The only point seems to be to get them to a weight which is acceptable for their chronological age rather than their adjusted age.

 

We had to do this as well until the girls were about a month old and were eating enough to get all their calories without any help.

 

I only had to do that for DS, but he had severe IUGR, so he had a LOT of catching up to do. I'd talk to your pedi about it - chances are you can do without it.

 

I had to do 24 cal with the twins until they were 6 months old. I think that was a little long, but I was SO thankful not to have to do it after that point!

 

Mine got enriched breast milk right up until they switched to whole milk at about 15 months (1 year adjusted). They did nurse some for the first 7 months, but also got bottles of pumped milk with a bit of formula powder and an additive called polycose (both for extra calories), and rice cereal (for reflux). It was a pain to deal with, but getting the calories in to them was so important - they didn't even make it onto the 5% growth curve for their adjusted age for many many months (and now at age 3 they are both around 50th %!)

Good luck!

Rachel

 

I haven't had any experience with having to do this, so first let me admit to my ignorance. However, my ped told me that the mother's body actuallly adjusts to and anticipates the baby/babies' needs. For instance, milk for a preemie infant is denser in calories than it is for a term baby.
Like I said, I'm a little ignorant, but is it necessary? Could you check with their ped and possibly a lactation consultant to see?

 

I agree it seems unnecessary.

We were told to do this by the peds at the NICU and our own ped says we have to do it until we reach the 25th percentile for the age.

Since they were born 6.5 weeks early I don't see how we are ever going to get there. We are around 3% and 6% at the moment, though for their adjusted age we are comfortably above the median.

I find this very frustrating as there is no academic literature which appears to study the effects of this force feeding. It And while I am sure that Mead Johnson loves the practice I can't help but think it is unnecessary.

 

QUOTE
our own ped says we have to do it until we reach the 25th percentile for the age.


Your pedi wants them to hit 25th% for actual age, not corrected age?! Especially when they were 6.5 wks early?!! :huh: STUPID!!!!! (IMHO, of course. )

You know what I'd do if I were you? Dump the extra calories. Just nurse (or give EBM if that's what you're doing) whenever they're hungry. Keep track of diaper output if you ever have any doubts. Print out growth charts for each baby, and whenever they get weighed and measured, plot the numbers based on ADJUSTED age, not actual age. That will give you a much better sense of how they're doing.

And besides, it doesn't even matter what percentile they are, as long as they're growing well and staying pretty much on their curve. The 5th percentile exists because some normal, healthy, thriving babies are going to BE in the 5th perentile. Some adults are 4'11", some are 6'5".

I totally agree with your gut instinct about this - those extra calories sound like a total waste of money to me.

 

I didn't bf but I had extremely low birthweight babies (3.5 and 4.5 at 36 weeks) and we only had to do 24 cal formula (straight formula) until they hit their due date...NEITHER of my kids have EVER hit over 5th percentile and they're almost 2! I'd measure diaper output and the fact that they grow on their own curve - my pedi has NEVER pushed me to feed them more than they will eat - even now with the toddler picky eaters I have...

 

we were sent home with those instructions, but I didn't follow them simply because my goal was to stop pumping and just nurse. Also, my boys were growing and gaining well. (50th percentile for reg. babies) I did supplement a bit with formula. FYI-if you were sent home with specific formula for preemies (ours was neosure) your insurance may cover--ours does--(the ped needs to write a prescr).

Good Luck

Lisa