LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Tina Boyce <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 25 Aug 2013 19:12:38 -0700
Content-Type:
text/plain
Parts/Attachments:
text/plain (46 lines)
Jean, 

Have you checked with dietician journals or professionals? We have dieticians that work specificially in our unit and calculate the dietary needs for each patient. They are the ones that would be recommending adding formula to EBM to increase the calories in our unit. This is common practice in my area. It sounds as though he is on a restricted volume (diuretic) but needs more weight gain.  He sounds like a failure to thrive infant also. I'm just putting pieces together from the several emails you've written. Painful, noisy gut movement is pretty much the norm for infants with colostomies. He must have had some gut issue. I'm thinking that the problems you are seeing are caused by his anomalies and surgeries rather than the formula. Don't get me wrong, there may be a way to get more fat in the EBM. I have not heard of any issues with kidney or gut damage from the concentration of the feedings. Of course, I'm not giving you reliable data here, just anectdotal info. We commonly fortify EBM to 26-28 calories/oz as needed. I don't get much feedback after the kids leave our NICU, so the kind of damage you are talking about would be issues on peds/PICU. I'm going to try to see if I can make contact with our dietician the next couple of days at work and pick her brain, and get back to you. Maybe our pedi surgery nurse practicioner also... I hear your frustration, and understand your questions. It would be interesting to see if he reacted the same way when the powder was withheld for a week....I know your granddaughter would probably not be willing to deviate from her instructions to try that experiment, from what you've said. But I suspect it would be the same with and without it, except for the potential weight gain....

This probably isn't very helpful, but I am thinking about you and your questions!  

Tina  :)

On Aug 25, 2013, at 3:19 PM, "K. Jean Cotterman" <[log in to unmask]> wrote:

> Does anyone know of reliable articles in professional health care literature about the safety of adding carefully measured amounts of powdered formula to EBM to increase calories for a full term baby with cardiac and multiple other anomalies who is not gaining weight at the approved rate??
> 
> 
> My granddaughter is caring for her baby at home, with visiting nurse visits. She has been following the directions given her by the surgical/pediatric staff in a major medical center, but reports that as soon as the fluid gets into the stomach via orogastric tube, her baby becomes and remains restless and fussy, and various noises in the gut begin right away, and continue for a while till there is finally a somewhat forceful exit of stool from his colostomy. She didn't report the color of the stool. Weight gain is hard to follow because he is also on a diuretic. If per chance it is being moved through the stomach and small intestine too rapidly for proper digestion and absorption, how is that supposed to result in weight gain? Maybe just enriching the calorie count of the stool?
> 
> 
> Somehow it seems as if the concentration of the fluid made by adding the directed amount of plain commercial powdered formula to the measured amount of breastmilk might make a solution so concentrated that it is somehow injurious to the kidneys themselves??? Or the gut??? An internet search turns up all kinds of impressions from parents themselves, plus directions that sound suspiciously influenced by formula companies, etc. I would like to know from professionals in the forefront of actual care whether babies given such supplementation are later having any kidney or GI problems as a result.
> 
> Does anyone know about the feasibility of increasing calories by skimming off cream from EBM and adding it to straight EBM? Is there professional literature on it? Somehow, that seems like something that would be easier on the kidneys and gut.
> 
> 
> K. Jean Cotterman RNC-E, IBCLC
> WIC Volunteer LC      Dayton OH
> 
>             ***********************************************
> 
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet welcome

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome

ATOM RSS1 RSS2