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Date: | Fri, 11 Jan 2002 12:52:14 EST |
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There is SOME evidence that ex-premies need fortification after discharge.
Remember, we are sending them home at 35-36 wks, not at full term. You can
get better growth and bone mineral density in the first year with
fortification/supplementation, but the effect washes out by age 2-8 in most
studies. Rich Schanler has a good set of recommendations and a good lecture
re who needs fortification at discharge.
R. Schanler, 2/2/01, San Diego:
•Can baby consume volume > 180 ml/kg/d ?
•Is weight gain adequate ?
•Are nutritional indices appropriate ? (Albumin, Alkaline phosphatase,
Phosphorus)
•If ALL responses YES:
– Exclusive breastfeeding
• At the breast
•Expressed BM
•Combination
–Term formula
•If any responses NO:
–Combination BF /EBM + enriched formula
–Enriched formula
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital, and Sharp Mary Birch Hospital for Women
Medical Director, Lactation Services, Sharp HealthCare
San Diego, CA, USA
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