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Subject:	Re: mixing formula with ebm
From:	Phyllis Adamson IBCLC <[log in to unmask]>
Reply To:	Lactation Information and Discussion <[log in to unmask]>
Date:	Tue, 30 Nov 2010 13:16:08 -0700
Content-Type:	text/plain
Parts/Attachments:	text/plain (76 lines)

Private reply now.

I am in email contact with the daughter of an administrator at my hospital. I have not met her personally. During the first months of his life, our NICU RN / NIDCAP specialist was working with her. But now that he is beyond 6 mos, that person referred mom to me as the "Knower Of All Things" - almost guaranteed to help her.

The daughter's baby is 8 mos old, born 5 weeks early at 7# 4oz, 19". Her water broke 4 days before her cerclage was due to be removed. His wt & ht were btw 25-50 %ile for the first 3 mos. By 4 mos, wt started dropping to 5%ile at 7 mos. But his ht grew to 75%ile at the same time.
She has been tracking data on a spreadsheet.
She stated babe has allergy to casein & whey. Don't know if that is from behavior observations or from any actual testing. Mom removed bovine products to her own diet, including those in ingredients lists. Reports some improvement.

Going to BF-friendly GI doc who wants babe to have 600 cals daily based on his assumption that babe gets 150 cals from solids. Mom says babe actually gets 30-60 cals from solids, based on her database calculations.
Cream level almost non-existent in her milk as per photo of 6oz EBM standing 6 hrs with maybe 1-2ml cream on top. She said that's more than usual.
All other behaviors normal. Mom reports developmentally maybe 1 mo behind his older brother at same ages.

So if calories are the issue, and if it is really true that there is a bovine allergy involved, do you think there is a way to add calories safely to stop this freefall in weight?

Of course, I'm doing this as the hospital's only LC and my reputation is on the line - so I feel.

Hoping for thoughts or ideas since you have worked with these weight loss situations before.

Phyllis

---- Linda Hill <[log in to unmask]> wrote:

=============
Phyllis, you bring up a very good point! This is what I get for being too
brief! The "recipe" I have uses powdered "enfacare 22". (which is 22
calorie formula, versus the regular formula that is 20 calorie)

I looked at the scoops in both the top US brands (of the 22 calorie formula)
and they were only about a cm off from each other. So, a teaspoon of either
of should be fine.

The 2nd recipe, which did not utilize EBM, was a regular calorie formula.

Sorry for all the confusion.

Linda Hill RN,IBCLC

Austin,Tx

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--
Phyllis Adamson, BA, IBCLC
Glendale, AZ.
[log in to unmask]

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