I just wanted to reply to couple of things discussed a few days to weeks ago
(sorry, always behind). Firstly Marilyn raised the relevant issue of the
density or specific gravity of milk and its relevance to test weighs.
>Either someone has determined that the
>density of breast milk is close enough to water that we can count it as 1
>gram/ml, or the scales specifically made to weigh breastfed babies are
>calculated so that they reflect the average density of breast milk.

 I just wanted let you  know that breast milk weighs 1.031 grams /ml. If you
are going to be really fastidious (eg: research) you should do the
conversion. However for test weighs done on scales that are only accurate to
+/-.005g (which is most) then really its probably close enough not to worry
too much. Although I don¹t have the paper to hand Peter Arthur did some
research and concluded that it was not necessary to calculate insensible
water loss in infants under 6 months of age when test weighing for feed
volumes, however if weighing the mother or babies over six months, due to
the increased level of activity and surface area, it was important to do so.

Also Nancy made a comment
>The research concerning adding DHA to formula/ABM is not clear.  DHA is a
>part of the complex web of nutrients, enzymes, growth factors and other
>factors in breastmilk, with a myriad of complicated interactions, of which
>we understand very little.  Simply adding it to formula does NOT imply it
>will function the same way, or at all!
Just out of interest I have a colleague who tested the formula on the market
that provides a capsule of so called DHA to add to the formula once it was
prepared. He found that firstly the capsule did not contain refined DHA
only, but was a mixture of certain oils, (evening primrose, fish oil and
some others). If he followed the manufacturers instructions for mixing then
he found that the capsule was not well mixed or evenly distributed into the
formula. He found he had to perform vigorous mechanical mixing (that a
mother would not normally undertake) for this occur. Apart from the very
important issues that Nancy raises it appears that not even the basic issues
of uniform distribution within the formula have been addressed. If oils are
used as the basis for administration of DHA there are problems of adherence
to the bottles and feeding tubes, and the fact that oils always settle to
surface rapidly after standing.

Regards
Cathy Fetherston RM MSc IBCLC

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