Dear Linda:

I don't know much about renal disease in infants.  I do deal with a lot of
adult renal patients who have kidney failure.  If the phosphate is a problem,
I would think that some type of phosphate binder could be used.  I don't work
in a children's hospital, so I am relatively unaware of all the formula
products on the market for special diseases.  I would think that regular
formula would be higher in phosphorus than Human Milk.  As for increasing
sodium in the milk..... sodium is increased during the  process of weaning.
 I don't think there is any way to increase the sodium in the milk other than
this way.

I would think that human milk would be the absolute very best for a baby with
kidney problems.  It is already low in protein, low in renal solute load, and
highly digestible.  One of the things one must always consider is that
individuals with kidney problems receive sufficient non-protein calories to
"spare" protein for growth and maintenance.  Breaking down protein for energy
will elevate the Blood Urea Nitrogen (BUN), thereby increasing the load on
the kidney.

I would think it would be very important to allow this baby to finish all the
milk on one side before going to the other side so that the fat intake would
be as high as possible.

I'm sure there are others more qualified to comment than I, but these are the
thoughts off the top of my head.

Martha Brower RD LD IBCLC (more familiar with kidney disease than I want to
be.  I have seen a tripling of renal patients in my nutrition practice in the
last 5 years!  I have often wondered if we are starting to see the results of
the ABM experiments of the 40s and 50s!!