Fortifying breast milk with formula--do they just eat less?

st.augbride

Ds has been home from the NICU for 4 months now and has been only on pumped breast milk. While he was in the NICU he got HMF added to the BM, but they stopped adding it toward the end of his stay and he gained weight just fine, so they told us we didn't need to fortify once home. He was born at 3lb 3oz and is now 11lb 4oz, so he's doing great, though his weight gain has really slowed recently. He was gaining about 1oz or more per night and is now at 1/2oz per night for the past month. One of the peds we saw recommended that we start fortifying the BM. We weren't thrilled with the thought of it since he's had GI issues, but finally decided to start doing so today. Well, ds normally eats 22-25oz in a day and today so far he's only taken 18 : ( I'm not sure what to do. Did your LO decrease their volume of intake when doing this? I almost feel more fluid is better... What has your experience been?

ShannonSky

I'm pretty sure DD still took about the same volume. I'd give it a few more days, he could just be getting used to the taste/consistency or something. GL!

SWR&MSM

Funny you should mention this as its been the only thing I've been able to think about for weeks!!!  DD came home from the NICU in the middle of February on 27 calories - enfacare added to BM.  She was doing fine, gaining about an once a day.  Fast forward to the middle of April and she was still eating the same total volume: 14oz/day, which seemed like an incredibly small amount.  The pedi suggested we back off to a 24 calorie mix and see what happens.  DD started eating more: up to ~18oz/day but she was only gaining about a 1/2oz per day. So far the pedi isn't worried about the drop in weight gain, but we will revisit the issue at DD's official 4 month check up in 2 weeks

The long and the short of it is, yes, I think with a higher calorie formula they will eat less.  It has a higher caloric content plus it is actually thicker than regular BM, so they fill up faster, at least that has been the case for my DD. 

IncogNeato

I don't really have an answer and I'm certainly no expert but to me, it seems like your LO did an amazing job of gaining weight and I'm a little surprised that they were so concerned even with his steady (but slower) gain. My LO was born at 5lb, 3.6 oz and at 5 months was 11lb, 9 oz. Her gaining definitely started faster and then slowed down (2 pounds in the first month, 1b, 5oz the second month, then about 1 pound or a little less each month since then. Her pedi says she's just a smaller baby and some gain slower than others.

I'm sure it helps that they can plot my LO's weight on the charts to see if she's staying around the same place on the curve (1-3%) and I would imagine it's harder to know what the curve is with a lower birth weight baby? Not sure how that works. Good luck, though! I hope he starts plumping up more soon!

ETA- you can see from my siggy how LO has gained and she has been gaining .5 oz or less per day for the past two or 3 months.