The new Meade Johnson Human Milk Fortifier can turn the milk pale pink to
almost rust colored. I posted this a while ago. The company does not state
this in any of the general instructions for use. They have apparently stated
that this is due to the new formula being more iron binding. They state this
is not a problem whatsoever. My question is, if it is more iron binding with
the milk, and human milk has less iron, although more bioavailable, then does
this make less iron available to the very babies who need it the most? No one
seems able to answer the question, or at least they don't even attempt it. I
have alerted the NICU staff I work with, as well as the neonatologists, and
we will be following Hct's. However, if they are lower, will anyone believe
it is from the HMF? The milk does not need to be thrown out. And I am not
sure why one sample of milk will turn one color, and another of the same
mother won't turn colors at all.

On another note, we are begining to start early trophic feeds, meaning very
early, small volume feeds for our tiny, sick babies. Is any one else out
there doing this? How do you get enough in those first few days so that no
formula is given? I am asking to mix the breastmilk  with H2O or glucose to
extend the amount, until the volume increases. I am curious to see what
others are doing. From what I understand, we have not started as yet, this
will be 0.5-1cc/hr. We would need 12-24 cc/day,  starting at 48 hours of
life. We don't always see that much in the first few days. Any thoughts?

Lisa Enger RN BSN IBCLC
Boston, MA

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