Susan writes,


<1 teaspoon = 15 ml

So, therefore if you add 1 teaspoon of powder (15 ml) to 50 ml of breastmilk it will yield 65 ml.>


That's the precise reason I didn't attempt to give her any advice myself, because DRY measurements and LIQUID measurements are not the same thing, one dealing with dry weight and the other with liquid volume, and changing both the total weight and partially, the total volume when mixed/dissolved. An "ounce" does not equal an "ounce" in both systems. And milliliter (ml.) was NOT a dry measurement of weight way back when I was in nurses training.  I can't imagine that THAT has changed in all those intervening years! 


If all this confuses me, I am certain it would be much easier to confuse her. She is trying to follow (to a "T") the directions given her in the NICU infant step-down unit of a major university medical center where there is at least one internationally known breastfeeding friendly pediatrician on the staff. (I doubt that that pediatrician was involved in his care, but I assume she would have some influence on standing NICU policies and staff training.)


Underlying all of this is my concern of what it does to the breast milk it's mixed with (re: iron absorption), plus the past comments on LN on what dangers the concentration of protein per ounce might pose to a baby's kidneys, and perhaps NEC. Though he is full-term, his anomalies mandated an emergency colostomy (soon to be reversed) which of course changes his whole gut situation. I have already received one private comment explaining that the practice of mixing dried formula with EBM seems to be based on presumption and lack of currently recognized problems, with no formal research. If there is any published research on the general subject, I would like to hear about it, and putting that on the list for everyone would be helpful.


Hoping to hear (probably privately, so as not to clog the list with specifics about artificial baby milk) from more NICU nursing, medical and pharmaceutically trained folks with more "hands-on" experience in actual mixing of dry weight measures with liquid volume measures than I. 


K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC    Dayton  OH

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