This is a new practice here in our NICU and was wondering if anyone else is seeing it and any thoughts. In the past we would use powdered formula to increase calories in breastmilk for those babies (primarily the preemies) too old for HMF. Now our dietician has recommended adding formula concentrate instead. She says it mixes better, is sterile(at least the first time the can is opened), and provides better absorbtion of nutrients. My concern is the displacement of breastmilk, the osmolarity increase, and the perception of sterility. I have asked other RD's and they state the osmolarity is defintely increased although our RD states this is not true. To me it is the same as the Ross liguid fortifier. Can anyone enlighten me, Dr. Wight is this a practice you see and does it have validity?

Lisa Enger BSN RN IBCLC
Boston, MA

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