I find this quite extreme starting HMF on day 4.Whilst we do use hmf in our
unit we generally give the babies a chance to grow with just having mum's
EBM.

Another thing is that most of our micro-premmie would start on TPN & Lipids
plus vitalipids via a umbilical venous catheter or central venous line.Feeds
are grade up as baby tolerates,depending on gut absorption,to 180mls per kg
when TPN etc is stopped and baby just has EBM.We don't usually add HMF until
babies are over 1-1.8kg and showing evidence of not gaining weight .It is
stopped once they are over 2-2.5kgs and constantly gaining weight.
The only time we leave HMF going past this stage if the baby requires extra
calories but due to some physical reason shouldn't get it through extra
fluid (EBM).

what was the reason for starting HMF so early in this EVLBW neonate.


Anne Clements RN EM BNS
Brisbane QLD
Australia

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