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Date: | Sun, 23 Oct 2005 08:41:21 EDT |
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Katie has described a situation of a slow gaining baby and the
recommendation to mix 1oz of powdered formula into 1oz of pumped breast milk. Leaving
aside all of the other parameters to check in order to evaluate what the
underlying problem might be, use of powdered formula in this manner is an off label
use of the product. Here are a few of the hazards of this recommendation that
come to mind:
- it over-concentrates the product. 1 oz of powdered formula is 30 grams.
The scoop in the can is 8.5 g. According to instructions on the back of the
formula can, 34 grams/4 scoops is to be used to make an 8 oz bottle of formula!
1 scoop of 8.5 g is supposed to be used for 2 oz of water to prepare standard
formula. In looking at the American Dietetic Assoc's calculations for
increasing the caloric value of standard formulas, their chart doesn't even go up to
the point of using 30 g of powdered formula for anything (even to raise the
caloric value to 30 calories per oz)!
- powdered formula is not sterile and can harbor bacteria such as
Enterobacter sakazakii throughout its entire shelf life. Mixing powdered formula into
breast milk neutralizes some of the anti-infective properties of breast milk.
Mixing a potentially contaminated product into human milk that is neutralized
by such a product increases the risk for disease in the infant.
- what will this type of concentrated supplement do to immature kidneys?
Why can't the mother use the cream portion of pumped milk that can be ext
remely calorie-dense? The mixing of formula into breastmilk recommendation
sounds very dangerous to me and this mother may benefit from a more thorough
work-up of her situation and a second medical opinion.
Marsha Walker, RN, IBCLC
Weston, MA
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