Ann has told us of a seriously ill baby whose physician wishes to start her
on hydrolyzed formula rather than breastmilk. The concern here appears to be
with kidney function and I assume renal solute load. The renal solute load of
human milk is 93 mosmol/liter, milk based formula 135, Pregestimil 141,
Nutramigen 290, Alimentum 330, Portagen 126. Check the renal solute load of whatever
formula the physician has recommended. The reference for these numbers is:

Jensen RG (ed). Handbook of milk composition. San Diego, Ca: Academic Press,
1995.

I have also e-mailed Ann a copy of my handout, "Just One Bottle Won't
Hurt..or Will It?" This looks at some of the side effects on the gut of supplementing
a breastfed baby with formula. As usual, I am happy to e-mail a copy to
anyone who wants it.

Marsha Walker, RN IBCLC
Weston, MA

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