Three Things You Should Know About "Fortified Breast Milk"

Even if a woman decides to provide expressed breast milk for her micropreemie (because- seriously- nursing at the breast is off the table at less than 26 weeks gestation...), the doctors may decide that the milk needs to be "fortified". Micropreemies are so tiny and just growing is one of the main things they need to do to get stronger. Sometimes, additional calories are needed to make this happen...

1. An "average" ounce of breast milk has 20 calories in it- the same amount of calories you'll find in one ounce of regular formula. Keep in mind that this is just an average. The nurses- just by looking at my milk- swore mine contained more fat and was likely higher in calories. But who knows? Doctors use "20 calories" as a starting point...
2. While it is true that things are being "added" to the breast milk (sometimes a bit of formula powder, sometimes "human milk fortifier", sometimes a substance that- no joke- looks like vegetable oil), all the benefits of the milk remain. There is nothing wrong with the preemie's mother's milk. The milk is not processed in any way that changes its composition- these substances are added for the sole purpose of fattening up that babe.
3. While the benefits of the milk are unchanged, the ease of digestion is compromised by the addition of these "fortifiers". Frequently, babies who receive fortified breast milk will start having "diaper problems" ranging from diarrhea to constipation to horrible rashes. Our daughter fell in that last camp and had such a horrible rash they put a barrier cream on her and left her un-diapered in the hope that would help her heal. She did- eventually- but it was horrible to see.

So there you go! Our C was on "24 cal" breastmilk even when we brought her home. This meant we bought Similac Neosure Advance to add to it, even though I diligently pumped for her. Still, we were lucky. When she hit one year (adjusted-- 16 months, calendar-wise), C went on just a typical diet. We have never needed to supplement her diet or add Pediasure or any of that. She's still small-boned and slim- she barely tips the scale at 30 lb at 4 1/2 years old. But she is healthy and- very importantly as all preemie parents know- ON THE CHARTS. :)

What three things would you like us to know?