Hi,

We have an infant who was transported to our hospital after cardiac surgery. 
This baby is needing fortified milk feedings. We are mixing the breastmilk with 
prepared 30 cal Similac to fortify the calories of the milk. 

I advised the NNP staff and neonatologist that this is not best practice per the 
HMBANA guidelines which state that mixing milk based formula with human milk 
decreases lysozyme activity in the milk. They want to know what the 
difference is between this practice of mixing and the other practice of feeding 
HM first, followed by formula - doesn't it all mix and effect the gut the same? 

They are reluctant to change his current feeding plan, as this baby was being 
fed this way in the larger city hospital from which he was transported. 

If there is any evidence based literature on this subject, please e-mail me 
privately at [log in to unmask], in addition to the list. 

THANKS!
Brenda Phipps, BS, IBCLC

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