breast milk fortification?

katie4253 · May 2011

I am a little worried. They are taking out his TPN tomorrow and they said they would start him on full feeds (20ml) and would be adding fortifier to it. The nurse said some babies have setback when they start fortifier because it isn't as easy to digest as breast milk. But, that they can't give him more milk because it would be too much liquid for his little body. I know the fortifier is necessary, but man, I'm nervous about it.

Anyone have any experiences to share?

kck329 · May 2011

Congrats on full feeds and one less IV!

Cora was on fortifiers until her last two weeks in the NICU and didn't have any big problems with them. I do think the second one she was on (a bovine fortifier rather than human milk fortifier) caused some constipation and gas but that was it.

As she was able to start breastfeeding, we weaned her off the fortifiers by adding more feeds of plain breast milk either at the breast or in a bottle if I wasn't there. She is on a breast milk only diet now, something that was important to me. If you have concerns, talk to the nutritionist in your NICU and ask them all your questions. Ours was wonderful, one of my favorite people on the team. She listened to my desire to have a breastfed baby and worked with me to send Cora home without formula supplements. However, I know that if she stops gaining weight I will need to supplement again and she gave me lots of resources for that as well.

schenkertobe · May 2011

My LO did not tolerate the human milk fortifier. He was throwing up the whole day they tried it. Fortunately they stopped it and instead mixed some formula with Bm for each of his feedings. Hope your LO does well with it!

JakesBride07 · May 2011

Both of my little one's needed HMF while I was breast feeding. Neither had any issues with it.

Hopefully your little guy won't either. Good luck!

bhilyer · May 2011

Both of my little guys were on HMF. My smallest one is still in the hospital and he's getting double HMF at each feed. Neither of my boys had trouble with it but I know other babies in our NICU have. There is some new research that shows a relationship between NEC and HMF in some babies. (Or at least that's what we've been told.) Like PP said, talk to the nutritionist and your neo team. Getting those extra calories is beneficial to preemies. You can also ask them about MCT oil. My little guy gets this in his BM at each feed as well.

damabo80 · May 2011

Any BM given to her has the fortifier in it as well. It does cause constipation. They have been giving her suppositiories to counteract this. And man, the suppository does its job. Tongue Tied

Natalie_may · May 2011

damabo80:
Any BM given to her has the fortifier in it as well. It does cause constipation. They have been giving her suppositiories to counteract this. And man, the suppository does its job.

This! They actually tolerate formula (they are now FF) better then fortified BM. When it was dropped to 22 cal they did better than the 24cal though. Good Luck!

SWR&MSM · May 2011

The Nugget had HMF added to her BM fairly soon after she got onto full feeds. They started at 22 cal then quickly moved up to 26 cal plus added protein. She tolerated the HMF well but I was warned that some babies don't which is why they add it slowly. Once they started adding the protein her weight gain took off. She came home from the NICU on a 27 cal diet - enfacare mixed with BM. Ditto talking to the nutritionist - we got a lot of good information from her. Our primary nurse was also a great source of info.

And congrats on getting that IV out!!!

SushiNoMore · May 2011

Same as the above. He was on HMF for awhile, and, if I remember right, they switched him to Neosure shortly before he went home. He tolerated the HMF fine, but he had crazy constipation with the Neosure (especially when they bumped him up to 27 calories). He was pretty big at that point, though, so it wasn't a huge deal.

Good luck!

kaylaaimee · May 2011

why was your LO on TPN? Scarlette had a huge setback that I believe was fom HMF- and she was part of the prolacta study. The other babies did great on it but it caused her to have medical NEC (not full blown NEC) and we spent 3 months on TPN as a result. She was (still is) unable to digest milk proteins. I refused the fortifier once they decided to try breastmilk again and so they used 30 calorie Elecare to fortify. She ended up not being able to have my milk at all though.

I think it really depends on the maturity of the babies digestive system. Of all the 25-27 weekers at our hospital, Scarlette was the only one to have an issue with the HMF.

Piper345 · May 2011

My son is currently eating 25cc of BM every three hours. They add fortifier and vitamins to this as well, and so far he is doing fine. He is a pooping machine Big Smile

He does have reflux which is VERY common for premature babies and he is taking zantac 3 times per day. The main cause for his for his brady episodes seems to be reflux and also sometimes while he is pooping...

adrielegorburu · May 2011

Madi was started on HMF very early on and had some constipation from it - but after a week or two shes been tolerating it fine and growing like a weed!!! It's all those extra calories! Oh and the (more than) occasional glazed doughnut I eat!

urbanflowerpot · May 2011

We had (and continue to have) absolutely no troubles

sandsandmore · May 2011

I don't know if it was just coincidence or not, but once HMF was added to my LO's BM, he got NEC. I'm terrified that they'll want to add it again, and I'll put up a stink if they do.

katie4253 · May 2011

kaylaaimee:
why was your LO on TPN? Scarlette had a huge setback that I believe was fom HMF- and she was part of the prolacta study. The other babies did great on it but it caused her to have medical NEC (not full blown NEC) and we spent 3 months on TPN as a result. She was (still is) unable to digest milk proteins. I refused the fortifier once they decided to try breastmilk again and so they used 30 calorie Elecare to fortify. She ended up not being able to have my milk at all though.
I think it really depends on the maturity of the babies digestive system. Of all the 25-27 weekers at our hospital, Scarlette was the only one to have an issue with the HMF.

He's on TPN because he isn't on full feeds yet. They don't want him to get dehydrated. He's never had any indication of NEC, but of course it is always in the back of our mind!

korpisar · May 2011

Mine started on fortifiers this past saturday. He has done well. They are taking out his pic line now because he is getting the extra nutirents in his food now. Good luck!

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