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XP: Fortifiers/Neosure in EBM

Sharra711Sharra711
in Preemies

After finding out that my 36 weekers were loosing percentiles in their weights at their 4 month appointment the Pedi, LC and I are working to find out the best thing to do, to get the calorie content of their "food" up.

Pedi wants me to add 22cal/oz formula to their diet, but I was wondering if anyone here had experience with adding powdered formula to bottles of EMB (increase calories, not volume). I'd like to mix neosure with the EMB that I have over just straight formula, because it's more calories.

I looked into the HMF, and they are so expensive and I don't think insurance will cover it, plus 90% of their feeds are at the breast.

They have been sent a referral to a nutritionist, and many of the people who said mixing powder/EBM is "ok" got their info from someone who knows about neato-diet.

Thanks!!

 

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Re: XP: Fortifiers/Neosure in EBM

  • caitdanacaitdana member

    I pumped for around 5 months and the girls were in the NICU for 3 months for one and 4 for the other so we had issues with BF. They were so small from the get go that we always had to add a fortifier to my BM. When Sophia was discharged she could get pumped milk or tried to BF for 7 feedings a day and for the 8th I would give her a bottle of neosure. That is how we increased her calories. My other peanut still has weight issues so we have always had to fortify every bottle for her. The nutrionist will have recipes for you. She will tell you exactly how many ounces of BM and how many scoops or tablespoons of Neosure. You wouldnt just add 1 scoop per 2 oz of BM. BM is 20 cal already where as water is 0 cal.  Sanity wise, it is much easier just to give straight neosure/water in one bottle then to make  measure every single bottle and add in formula to it. But that will be something you will have to talk to the nurtionist about.

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  • bhilyerbhilyer member

    I used powder to increase calories without increasing volume for one of my guys for 9.5 months.  You can add any powered formula to BM to increase the calories.

    I was mixing BM and Similac Sensitive to 27 calories by adding 1 tsp. formula powder to 45 cc of BM.  Not sure about the "recipe" for 22 calories.

    I know there are some moms that have chosen to do 2 or 3 bottles a day of higher calorie formula and the other bottle of pure BM.  It's helps with mixing and measuring, but the result is the same.

    I would definitely meet with the nutritionist if your insurance will pay for it.  Our nutritionist is well worth the extra appointment.

    So are your twins are 4 months old?  Something else to keep in  mind -- when you start solids, you can use higher calorie formula to make purees, cereal, etc at high calories.  And try to incorporate healthy, high fat foods like avocado to your rotation.  Even though solids are just for practice in the beginning, every calorie counts Smile

    Good luck! 

     ETA - I forgot I had this link saved.  It has the recipe you'll need:

    https://www.childrensmn.org/Manuals/PFS/Nutr/018727.pdf

     

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  • Mrs. AliceMrs. Alice member
    My boys had been EBF but not gaining enough weight for their adjusted ages.  At their 6 month appointment their pedi told us to give more fortified bottles.  I have so much frozen BM in my freezer from their NICU time that I really don't want to go to waste so she gave me a recipe to just use BM with Neosure (22 cal preemie formula) powder added.  We add one teaspoon to every 3 oz of EBM to make 23 cal.  I also asked about HMF but she told us it is very expensive and nearly impossible to get approved, plus the other version adds just as many calories.  We've only been doing it a few weeks so I've yet to see how much they have gained.  Good luck!
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  • prepster7prepster7
    We just did what the NICU docs told us to. I mixed Neosure with pumped BM. When I first brought DS home, he nursed half the time. The other feedings he drank the fortified milk from a bottle. We were also told to offer the bottle after DS nursed; sometimes he would drink more that way as bottles appeared easier than breast for awhile there. The funny thing is that DS's weight gain sped up when we stopped giving him the bottles of fortified BM and he just straight nursed. Maybe a coincidence. I don't know.
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  • Sharra711Sharra711
    imageBostonKisses2:

    Does the nutritionist you got a referral to have preemie experience?  You can ask, and if you're not comfortable with someone who doesn't have a lot of preemie experience, ask for another referral to one who does. 

    I have no clue at this point, but I'll check them out, Thanks!

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