I am feeling frustrated that I keep meeting moms who have been advised to mix powdered formula directly into their breastmilk in order to increase calories.  Some of them have babies who are failure to thrive and some have babies who are gaining slowly.  I was under the impression that this practice puts a baby at risk for kidney stress and dehydration but I am finding the advice to be very commonplace.  The usual suggestion is to put a teaspoon of PIF into 3 or 4 ounces of expressed breastmilk and feed this to the baby by bottle.

I checked the archives and found this post.

http://community.lsoft.com/scripts/wa-LSOFTDONATIONS.exe?A2=ind1012A&L=LACTNET&P=R583&1=LACTNET&9=A&J=on&d=No+Match%3BMatch%3BMatches&z=4

Does anyone else have any evidence (other than common sense) that demonstrates that this is not a good practice?  Why is this practice recommended and is there any evidence to show it is beneficial?  What about for premature babies?  Also, shouldn't off label use of PIF be evidence based?  I am very frustrated that I need to show it is unsafe.  Isn't the burden of proof on those who are using this product off-label?  How can a pediatrician or nutritionist advise this without proof that it is safe?

Now that the AAP is advising a decontamination step (recommended by WHO) for PIF, how does that affect this practice?


Laura Spitzfaden, LLLL, IBCLC

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