I agree there may not be a need to fortify based on the caloric content.  But in my NICU unfortunately we don't have a creamatocrit (correct term?) for determining individual calorie counts.  The assumption is 20cal/oz.  Frankly I'm not a fan of Neosure either as a preemie formula or as a fortifier--it seems to cause particularly acid stools and we often see irritation and excoriation of the skin in those babies on it.  But this is the practice in my NCCU and I submit it for your information.
K. Reid, RN, BSN, IBCLC

________________________________________
From: Lactation Information and Discussion <[log in to unmask]> on behalf of Jan Barger <[log in to unmask]>
Sent: Tuesday, February 23, 2016 1:48 PM
To: [log in to unmask]
Subject: Fortifiers

Kathie says,



<<In our NCCU as the babies get closer to discharge, we use  powdered
Neosure instead of HMF to fortify breast milk.  This is what they  go home on.
We fortify it to 22 or 24 calories.>>



I'm curious --  do you routinely figure out what the caloric content of the
mom's milk is before  you fortify it further?  What if the caloric content
of her milk is already  24 or 25 cal/oz?  Aren't you then overfeeding this
baby  unnecessarily?  What if it is only 17 cal/oz -- how do you know you are
 putting enough neosure in the milk?

I'm not flaming,  just wondering what the thinking process is....since we
know that all mother's  milk is different, and isn't all 20 kcal/oz.

Jan Barger, RN,  MA, IBCLC, FILCA
Wheaton,  IL


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