Fortifying my Breastmilk

[@llli*anitabonita]

Hi All--

My twins were born at 34 weeks and 3 days. They are actually doing well breastfeeding and my supply is fine, too. (I have been pumping like crazy).

Yesterday, when they turned a bit past 2 weeks old, they told me they wanted to start fortifying my breast milk. Today, when I brought my daughter home they told me that I could either

a) Pump and fortify my breastmilk with neo-sure preemie infant formula when I give my daughter all her feedings with a bottle

or

b) Breastfeed and then give her two bottles of preemie formula a day.

This annoys me to no end. I want to exclusively breastfeed my twins and it looks like that's a real possibility if I ignore their advice. But I also don't want to damage my twins' growth (as they were implying if I do that).

Your experiences and advice? I know preemies are different, but the doc recommends I do this for 6 months....which I think is absolute BS.

At this point, we are not exclusively bfing, so when I give my daughter a bottle of my breast milk, I am fortifying it. That said, I think she could go full time bf pretty soon.

Thanks for your help! I feel like I don't have a lot of time to research this before I have to make a decision.

[@llli*sixyearplan]

My initial reaction is that's weird advice. How are wet and poopy diapers and weight gain?SIX MONTHS of fortifying is outrageous. Assuming growth is in the normal range I would ignore the advice and do what your body is meant to do.

[@llli*mommal]

I know next to nothing about preemies, but my gut also says that the advice you got is weird. 6 months of supplementing... If weight gain is good, and they are developing normally, why in the world would that be necessary?

I think you should contact a lactation consultant, preferably one who is also an IBCLC. They tend to be more knowledgeable about breastfeeding that most doctors, even the good ones.

Congratulations on the new babies! What a hectic time you must be going through.

[@llli*bunny.scootles]

Did they say WHY they wanted you to do this? Is there something they are concerned about? Is it "standard procedure"? What are the risks of using it, what are the risks of not using it?
I'd also talk to an IBCLC and see what she says!!

[@llli*jenniebean5]

Congrats on your babies!

How's their weight gain?

We went through this too. My son was born at 29.6 weeks and when he was in the NICU they put human milk fortifier in with my breast milk for his feedings. The neonatologist said it was extremely important for him to get this in with his breast milk for at least 1/2 of his feedings until he was 6 months old. Well, when it was time for him to come home, I asked about this again and he was all waffly on what he'd said earlier and said there's really no good way for us to continue fortifying the breast milk with human milk fortifier once he's home (I don't get why not - it was in little packets in the NICU that were just poured into the breast milk and shaken!). I really wanted to exclusively breastfeed my son and not pump and bottle feed so I decided I would take this advice of it not being very feasible and within a month of him being home we cut all bottles out and were just breastfeeding. He's been home for about 3 1/2 months now - he was like 5lbs 14oz when we brought him home from the hospital and now he's 13lbs 3oz...so he hasn't had any problem gaining weight being exclusively breastfed!

Oh, and one thing I did to reassure myself and his pediatricians about nursing and his weight was I rented a baby scale (and I saw recently that Target sells them) and weighed him before and after feedings and once every evening and kept track of how much he was taking in during nursings as well as weight gain from night to night to show them the progress. This helped the process a ton!

Good luck mama. Let us know if you have other questions!

[@llli*nolies.mama]

I never fortified with our son and was never asked to. He got BM and BM only. Is their weight fine? Are they gaining? Can you get another dr.'s opinion?

[@llli*anitabonita]

Thanks for the info and support you've already given!

It seems like it's standard practice for this hospital's NICU, but the dr who gave the advice is very new. My favorite lactation consultant today had MUCH better advice: fully fortify two bottles a day.

The "issue" is a bit weight gain and a bit bone development. Because they are preemies, they are supposedly missing on some nutrients from the last trimester.

However, all the research I've seen says that fortifying breastmilk is the most important for extremely low birth weight babies, babies born at less than 3.1 lbs. my babies were actually big for 34 1/2 weeks: 4 lb 8 oz and 6 lb 1 oz.

I have scales at home and my daughter is eating well at the feedings I'm measuring and I'll check weight gain tonight. Tomorrow we go to our regular pediatrician and I'll ask his opinion. Today's nurse said that peds are more liberal than the neonatologists b/c the peds see thousands of ways to thrive and the neonatologists see one narrow path.

I've never known how important nurses were to good health care until the last few months.

[@llli*emmanuel.s.mom]

Congrats on your babies!

How's their weight gain?

We went through this too. My son was born at 29.6 weeks and when he was in the NICU they put human milk fortifier in with my breast milk for his feedings. The neonatologist said it was extremely important for him to get this in with his breast milk for at least 1/2 of his feedings until he was 6 months old....

I had a similar case with one difference. My pediatrician and NICU docs and nurses were adamant that B will suffer vitamin D deficiency which will make his bones brittle and that he will get anaemia if he doesn't get his vit and iron drops. Now the PD is on my case about iron supplementation to my breastfed baby of 4 months. He was born prematurely and had several gastrointestinal problems that he has gotten over only a couple of weeks ago, during which we had to take him off iron drops and vitamin drops as per the gastroenterologist. Now the PD is concerned about anaemia which he says is more severe at around 6 months in preemies. How valid is his opinion and shouldn't I delay his solid food intro with iron supplementation until his body is stronger?

[@llli*jenniebean5]

I had a similar case with one difference. My pediatrician and NICU docs and nurses were adamant that B will suffer vitamin D deficiency which will make his bones brittle and that he will get anaemia if he doesn't get his vit and iron drops. Now the PD is on my case about iron supplementation to my breastfed baby of 4 months. He was born prematurely and had several gastrointestinal problems that he has gotten over only a couple of weeks ago, during which we had to take him off iron drops and vitamin drops as per the gastroenterologist. Now the PD is concerned about anaemia which he says is more severe at around 6 months in preemies. How valid is his opinion and shouldn't I delay his solid food intro with iron supplementation until his body is stronger?

It's my understanding that vitamins with iron are very important for preemies because they aren't able to store up iron while in the womb for the last few months that would last in their bodies until about 6-9months of age. We do give Owen vitamins with iron - at first in bottles but we stopped giving him bottles on a regular basis so I just give him the vitamins with iron twice a day in his mouth. Because they taste bad, I follow up with another medication right after to help get the taste out. And I lay him on his back, hold his cheeks and stick the dropper in his mouth and squirt it towards the side/back of his mouth so he doesn't spit them out. I nurse him after he gets his vitamins and medications to help with the taste.

As far as solid foods go, if you give your little one the vitamins with iron, you wouldn't need to give solids to get iron into him. I do not plan on starting solids with Owen until he is close to 6 months adjusted age or even after, depending on his weight gain and his interest in them. But at least I know he's getting the vitamins and iron he needs each day without the solids.

[@llli*lulu.mom]

They did that at NICU and I fallow up once we were home... Human Milk Fortifier for a little while until she gain good weight.... alone with other Vitamins and Iron.... But my baby was very small, your little ones seems to have good weight to me, but I am not a dr

About Breast Milk not having Vitamin C, or D, or B, how true is that? This is the third time I read about Breastmilk not having those elements and the importance of sintatic Vitamins....