1- Many doctors do not know the current nutritional recommendations. 2- Saying 22 or 24 cal is an easier way to say supplement with mutlinutrient fortifier. When I order breastmilk fortified with NeoSure to 22 calories I am doing it for the extra protein, calcium and phosphorus, not the extra calories, but the calculations are based on calories - simpler for nurses and parents. Nancy Nancy E. Wight MD, IBCLC, FABM, FAAP Neonatologist Sharp Mary Birch Hospital for Women and Newborns Medical Director, Sharp HealthCare Lactation Services San Diego, CA [log in to unmask] (mailto:[log in to unmask]) *********************************************** 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