to fortify or not, please help

I wrote asking anyone for their experience/advice on fortifying breast milk or not (wrote yesterday, Tues. 4 Feb) but haven't heard any feedback. Anyone out there who can help?? I did talk to the dr. today and he said that in the last 2 weeks she's gained 250 gr and that I can fortify if I want, (if it "calms me down") or not fortify. I find that she eats sooo much better when the milk isn't fortified but I'm worried that she won't put on any weight if I don't fortify.

Report post

10 replies. Join the discussion

I have a former 33 weeker who is now 6 months actual. She was 3lbs 12 oz at birth, spent 7 weeks in the NICU. She was discharged at 6 lbs 1 oz. She is now 14lbs 1 oz (that is 10th percentile for her actual age) and i did not fortify. SHe ate great from day one at home and I did not want her to have any formula (although I know it is important for preemies in certain circumstances and would have added it had she not grown so well). I do give her a vitamin daily and a med for reflux. She is doing great!

Report post

I just got off the phone with my sister the supermom. Her suggestion was to stay off the fortifier and just try to up the quantity of milk she drinks in a day. That way she is getting more calories from milk. I'm going to do that and try not to obsess. grrrr, hard for me.

Report post

I believe around 4 months adjusted, we stopped fortifying. He drank as many calories w/o fortification as w/ the fortifiers, so we opted to go w/o it.

His weight did slow down, but my impression was that babies' weights do slow down around that time.

Although weight gain is often associated with good health, keep in mind that ironically, breast milk babies tend to be lighter than formula babies.

One of our son's neonatalogist said that while they like to see weight gains that follow an appropriate trajectory, gaining weight too fast wasn't good either b/c it wasn't "healthy" weight.

Also, children sometimes gain weight in fits and starts. There were weeks when our son didn't gain weight. And then weeks when he made up for it. So as long as she's gaining from doctor's appointment to doctor's appointment and her doctor says that the amount of the gain is fine, then I wouldn't worry.

I think that the phrase if it "calms me down," means that the doctor doesn't really think it is necessary. It would be more for your nerves than for your daughter's health.

Why not continue w/o fortification if she is better in terms of consumption when it isn't fortified? If she doesn't gain weight by the next's doctors appointment, then they'll tell you to bring back the fortifiers.

Report post

My youngest was born at 32 weeks, 3 lb 15 oz and came home 8 days later weighing 3 lbs 10 ozs. Because he was still so small we were told to fortify 2 bottles to 22 cal a day to help him grow. We did this (all other feeds were breastmilk) and by 6 months old he was all of 12 lbs 2 ozs. I asked his ped how long we should do this, and he said at least to a year, not so much for the weight but because it helps with brain and bone growth and development. I kept him on it until 10 months when he refused to take it anymore. He is now 17 months, still breastfeeding, no fortifier and weighs a mere 19 lbs 9 ozs.

Good luck, HTH :)

Report post

I did not have time to read the prior posts - sorry if I repeat anything:) We had to fortify both of our twins milk for a long-long time and now they are on Pediasure, but if your doctor is okay with it...I say try not fortifying and see what happens. Try for a couple weeks and maybe take her back in to be weighed (I am guessing they weighed her this last time to have a comparison:). Then if she is okay - keep going or discuss the situation again with the ped. I am so sorry I must have overlooked your post before:) Hope this helps! Good luck. Let us know what you decide and how it goes!!

Report post

I've decided to NOT fortify and just wait til the next appt. and see what her weight does. I think she's up to drinking more milk at at least some of the feedings so I'm going to try to pump pump pump and give her 6 oz bottles each time in the hopes that just by shere volume of milk her weight goes up without needing the extra calories from the fortifier.
I had a complete breakdown last night and this new worry just tipped it off. I know it's the mix of worry/anxiety/sleep deprivation. Deadly cocktail.
I try to be as informed as possible but sometimes reading things on the internet is pure poison and only sends my mind reeling. I see all these initials (RSV, IUGR, etc etc) and find myself rushing to google to see what they stand for and all possible symptoms so I can judge whether Grace could have it. AHHHH. This is honestly doing my head in.
I have decided to just feed her as much milk as she'll drink and ENJOY HER. My father said something and it is true for me....if you just spend your time worrying about her, you'll soon wake up on the morning of her wedding and wonder WHY you spent all that time worrying and not enjoying her.
This is my new mission.

Thanks for all your comments and suggestions.

Report post

I suggest to do what you feel is best for your little one. If she's gaining weight and progressing stick with it. I don't always choose what is suggested to me by the Dr, I know my baby better and I'm not going to to anything to hurt him. I only use the internet to compare notes, feels good to know you're not the only one going through "preemie problems".

Keep up the good work! And welcome to the worry full world of motherhood. Just wait until our little ones start driving, AAH!

Report post

If the pretty girl in your account pic is the daughter you're referring to about the fortifier...I think she'll do fine without the fortifier. We stopped fortifying at around 2 or 3 months adjusted because Casey was gaining too much weight (sounds crazy doesn't it?). I would discuss it with your ped, of course. BTW...Your girl is beautiful.

Report post

Thanks, Mama_Cyndi,
She's a keeper, that's for sure! I've decided to go off the fortifier and she's drinking more BM without it! Obviously the stuff turns BM into a milkshake and isn't as into that. ha ha
Your little one (boy, right?) is adorable too.
BTW, she's 4 months adjusted now (6 actual) and 12.5 lbs. Does that sound low to you?
We'll just see what her weight does without the fortifier over the next few weeks.

Report post

I love your new mission of enjoying your daughter! I'm going to try to do the same!

In case you are still wondering (not worrying!) about the fortifying issue, though, I'll share my experience. Our little girl was tiny, with severe IUGR, so everyone was worried about plumping her up. In the hospital, they started giving her half my milk and half fortified Similac Special Care, eventually bumping the formula so that the mixture was 30 calories/ounce. Oddly, Becca's growth slowed down when they started adding formula (and supposedly adding calories), so they tested my milk and discovered that instead of the average 20 calories/ounce, mine actually contained 29 calories/ounce - which mean that Becca's milk was fortified up to 34.5 calories/ounce - wow! No wonder she was fussy all the time - it was giving her quite the tummy ache. When we went home, they had us fortifying every bottle, with the hope that we'd be able to nurse. Even then, though, they wanted at least 1 fortified bottle, not for the calories, but for some of the extra nutrients, particularly to boost brain and bone development. Since she wasn't able to nurse, we ended up fortifying every bottle, until we realized that she was plumping up MUCH faster than she was growing length-wise! She's a chubby girl! So we backed off on the formula but still add the equivalent of one fortified bottle over the course of all of her bottles so that she can get the extra nutrients. She doesn't seem to mind it, and I often give her the formula at her night feeding so that she stays full longer (and thus sleeps longer!). She's also on the nasty green vitamins (with iron) that they recommend for all breastfed babies.

So, in sum: fortifying isn't just about the calories.

Hope this helps!

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Discussion topics

Preemie links and resources

Narratives from the NICU -- Read the special report

Community leaders