Fortifying breastmilk with formula

[MoMuM7]

DD was very low birth weight due to undiagnosed IUGR though born full term. His weight gain has been slow and I'm worried to bits. I've been advised by HV to fortify my breast milk with powdered formula to increase caloric intake. Have you done this and what was your experience? How many bottles a day did your offer and how did your LO react? Any allergies, what brand of formula did you use? I was hoping to EBF but I'm desperate for DD to get all the calories she needs.

Most kids have some dips that then correct around their birth centiles. Its the baby who suddenly plunges below two or more growth curves or through the 0.4th who is of the most concern. IF that ever happens or your just plain worried head to a peadiatric A&E department and ask for a check up. IF breast milk needs fortification it is far better to seek out and then follow the advice of an NHS peadiatric dietician esp for a young baby. Some babies who appear not to thrive might have a hidden extra need that is making it that bit harder for them to grow and gain weight. Some may simply take in enough fore milk to stop feeling hungry but not quite enough of the calory dense hind milk to gain weight and grow as they could.

In my DD case the childrens hospital continually suspected Silver Russel. Turns out she is just very small and will need to stay on a high calory diet to stay a health weight. Her sister is petite too. Her brothers are huge! If she switches to a normal diet she rapidly loses weight. Months of tests with no sinister reason ever been found for her doing that. Her Drs think she just is as she was meant to be. Small and fiesty.

Hope the La Leche league are as supportive of you as you continue to breast feed as they were of me.

US formula isn't the same as UK formula so shouldn't generalise advice from there to here. However I also found same as you - some articles about it being done in NICU wards. So I think if it is something that is done, however infrequently, it probably isn't so dangerous it could cost a baby their life. However, definitely seems questionable.

How often is she being weighed? I hear about bad weighing practice so often and parents being given unnecessary anxiety - the thing is that it's completely normal for weight to fluctuate as we eat, drink, wee and poo (as well as sweat and other methods of fluid loss) although these add up to tiny amounts, those tiny amounts can look like big dips/hills on a little baby's weight chart, and that's really unhelpful. This is why you want to look at the longer term overall picture and pattern, which can be difficult because it can feel so incredibly urgent and like you need the information immediately. Is the baby dipping over and under their centile line? Bouncing between two? (these are both normal patterns) Or are they cascading down through several lines? (more concerning - needs investigation). You can get so obsessed with what the exact gain is in grams between one weigh in to the next and it is so so so demoralising when they gain the "wrong" amount but this does not necessarily mean anything is wrong! Babies do not grow in a linear way and actually put weight on in spurts. It would probably actually be more productive to be weighing babies several times a day (although the stress of this would likely be counterproductive) so that you can see a more overall pattern, or once a month so that the pattern has time to smooth out - the in between is a problem because you end up with a muddled and confused picture, which doesn't really help anyone.