[JKRN05]

Is it common practice to add Nutramigen to EBM for weight gain?

[WeeBabyRN]

Originally Posted by JKRN05

Is it common practice to add Nutramigen to EBM for weight gain?

We add Similac Human Milk Fortifier to EBM to increase it's caloric content.

[dawngloves]

Not common here. If the baby is going home we start adding Neosure.Easier to obtain and less expensive than HMF. I don't see why you couldn't use Neutramigen for term babies with soy and milk allergies. Perhapes you can get in touch with Enfamil.

[prmenrs]

We use HMF for younger premies and Neosure for ones >34 wks and close to d/c. I don't see any advantage to Nutramagen. Not to mention that it's stinky stuff.

[SteveRN21]

We fortify our MBM with Natural Care Advance....apparently JCAHO says we shouldn't use powdered fortifier b/c of infection control issues..we used to use sim's powdered HMF....don't ask me why (what about our powdered formulas??!!)

We're also told Similac is no longer making Natural Care, so we're planning on using Similac Special Care 30kCal to fortify once we run out.

[Gompers]

Originally Posted by prmenrs

We use HMF for younger premies and Neosure for ones >34 wks and close to d/c. I don't see any advantage to Nutramagen. Not to mention that it's stinky stuff.

Tell me about it! My daughter just spent a week on Nutramigen and Alimentum - disgusting stuff. I was almost glad that it didn't work! Plus it's very expensive so I don't think it's a great option for NICU babies post-discharge unless they really need it for the hypoallergenic properties.

We use HMF once the preemies get to full feeds, and then once they're 33-34 weeks and getting ready to go home, we fortify with Enfamil Enfacare powder. We don't do any of our own mixing though - the dieticians do it under a pharmacy hood.

If we're talking about fortifying the EBM for preemies, it's just a better idea to use either Enfacare or Neosure since they have the minerals and fat content needed for growing preemies.

[lovemyjob]

Our director does his research primarily re: nutrition and our unit stoped using HMF because it is linked to increased infection (not sure if that is nec specific or not.) I am not sure if it is from the fact that it is powder and would require mixing in the unit and not under a hood, or if there is some other reason. I do know that pwdered formulas should not be given to the premature gut because of its increased incidence of nec.

We only use the nutrimigen or alimentum rarely, I think the kid has to have several trials on other formulas before the idea of allergic reaction comes into play. We also mix the breast milk with the Enfamil preemie 24 (which gives a 22 cal/oz mixture if 1:1) or the sim special care 30 (which gives approx 25 cal/oz if 1:1) depending on what the needs are.