I am working with an infant girl, 6.11 pounds at birth, who dropped to 6.1  
by day 5.  With a bili of 22.5 she was rehospitalized.  On day 3 and  4, the 
pediatrician decided she needed more calories to try to bring down the  bili in 
an effort to avoid hospitalization, so he ordered the parents to  supplement 
breastfeeding with concentrated liquid formula diluted at 70% of the  
recommended water:formula proportion "to give her more calories".  Has  anyone heard of 
this before?  I was concerned that this would be hard on  her kidneys, and 
digestive system in general.
 
Second question:  is it possible to fortify formula with human milk  
fortifier to achieve the same outcome?  I asked the question, but he didn't  get it 
and said she didn't have enough breastmilk to bother.
 
Baby's bili was down to 13 within 24 hours and she was released, but is  
still on concentrated formula and breastmilk until she reaches at least 7  pounds. 
 
 
TIA,
Barbara Ash, IBCLC
Falls Church, VA

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