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Date: | Thu, 25 Feb 2016 12:04:15 -0500 |
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I realize there are many new people on the list-serve. Please go back in
the archives.
In the hospital, it is impossible to get the recommended amounts of
Protein, Ca and Phos by simply increasing the volume of feeds for very low birth
weight infants - you would fluid overload them, open the ductus, cause worse
chronic lung disease,. etc. Calories are not the big concern - we can
always use hindmilk. Protein is almost always the limiting nutrient for
appropriate growth, both in the hospital and after discharge. Human milk is
extremely low in protein.
We do not use powdered formula as a fortifier in VLBW infants. We switch
to it a few days before the infants go home, if, when our neonatal
dieticians do the math, the infant is not getting enough Protein, Calcium and
phosphorus for growth and bone mineralization, or is not growing on human milk
alone. The risk of enterobacter sakazakii has been overblown. In 36 years
I have never seen a case.
Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, San Diego Neonatology, Inc.
Medical Director, Sharp HealthCare Lactation Services
8555 Aero Dr. #104
San Diego, CA 92123
858-939-4185 (office)
858-939-4298 (NICU)
858-493-0198 (Pager)
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