And I explicitly want to consent to this posting as well, even though this 
list is not meant to be a voting system.

Bye,

Marianne Vanderveen IBCLC, Netherlands (now off to bed after skyping with an 
abroad first child who never had one single scoop of formula, like the 
second and the fourth; the third had a couple of bottles (and got badly 
constipated...) when I was recovering after I escaped death from childbed 
fever and had to relactate (with success)... no talk of donated milk sixteen 
years ago...)

-----Oorspronkelijk bericht----- 
From: Susan Burger
Sent: Wednesday, December 01, 2010 12:06 AM
To: [log in to unmask]
Subject: Re: [LACTNET] Messing with scoops

Dear all:

I am speechless.  There is a body of literature on how messing with formula 
concentrations can lead to hypernatremia.  It is beyond me, why, with no 
evidence to back this, scoops of formula are being added to breastmilk just 
because a mother may not want to give formula.  Just because it is more 
calorically dense doesn't mean that she is not giving exactly the same 
amount of formula solids, it just means that there is less water which is 
not as good for the baby's kidneys.  Similarly for overdilution. 
Furthermore there is a whole body of literature showing how even highly 
intelligent parents make mistakes when mixing formula, so I personallly 
never recommend it myself.  When it comes to premature infants and the 
additional minerals they need -- I am completely out of my depth and don't 
touch that situation with a 10 foot pole.

Furthermore, the FDA recommends against using powdered formula in the first 
21 days of life --- due to the possibility of ESak.  Given the choice of 
sterile formula versus unsterile formula, I would chose the later -- and so 
would most parents if it explained to them.

To leave a parent thinking they are giving LESS formula just because it is 
in a more concentrated powder is not what I would call informed consent.

Sincerely,
Susan E. Burger, MHS, PhD, IBCLC

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