How many gestational weeks of age, or what does the weight of a baby
need 
to be to switch from a 22 calorie ABM to mother's own milk for
following 
with after breastfeeding? I am asking about discharging preterm
babies.If 
some babies need more nutrients and calories after hospital discharge,
It 
seems they may be sent home with instructions to use 22 calorie ABM for
a 
certain amount of weeks instead of breast milk fortifier that is used
in 
hospitals.

There is hardly ever a reason to use ABM if a mother's milk is
available.  So even if more calories are needed for growth of the
preterm or sick baby, the breastmilk can be fortified and supplemented
through an SNS while baby is at the breast OR the mother's milk can be
"lactoengineered" and hind milk used primarily (if mom has a good
supply) OR if the infant is not able to actually breastfeed, the
breastmilk can be fortified for bottle, cup, tube, etc. feedings.  The
22cal/oz formulas that are promoted as "transitional" formulas are
marketed to provide extra calories for preterm infants throughout the
period of life they need a boost for catch-up weight gain.  But they are
not meant to be substituted for mother's milk.  
 

Ginger Carney, RD, LDN, IBCLC
Clinical Nutriiton Mgr./Lactation Consultant
Le Bonheur Children's Medical Center
Memphis, TN  
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