Preemie that Only Tolerates Breast Milk.

prmenrs, RN · May 14, 2008

I don't have any experience w/that product, but it's worth a try IMO. Let us know if it works out.

iyqyqr · May 14, 2008

I'm assuming you've tried Pregestimil already, because it is easily digested and often used post NEC issues on preemies whose moms are no longer lactating. Some babies hate the taste and won't nipple well and then we've used Neocate, which is more palatable and also easily digested. You might see if you could give that a try. Good luck.

Hey Everyone,
Just wanted some insight on an issue with a preemie I care for.
Ex 23 weeker now almost 40 weeks whom does not tolerate any fortifer or formula. Only tolerates breast milk and is not gaining weight. We have tried hindmilk for 3 weeks with no success. No acidiosis either. Has anyone used any Prolacta products? Any other suggestions?
Thanks:nurse:

elizabells, BSN, RN · May 14, 2008

Alimentum might be worth a try. Don't use it much at work, but my cousin was unable to breastfeed and the baby wouldn't tolerate anything but Alimentum. Now he's 8mo and 25 pounds, still on only Alimentum.

littleneoRN · May 14, 2008

I have seen Prolacta used a few times. Not for any baby I was caring for directly, so I don't know too much about it except that it is expensive but has seemed to be helpful for those kids.

SteveNNP, MSN, NP · May 14, 2008

I'm sure you guys have ruled out a cow's milk/derivative allergy, right??

Most formulas and fortifiers have cow's milk derivatives, so maybe a trial of soy-based formula would help?

RN2B73 · May 15, 2008

I am a pre-nursing student with an interest in NICU and was just hopeing someone could tell me the difference between levels of NICU?

SteveNNP, MSN, NP · May 15, 2008

I am a pre-nursing student with an interest in NICU and was just hopeing someone could tell me the difference between levels of NICU?

Run a search on the topic here on Allnurses, or just look back at some older NICU threads. There have been several on the topic.

Now, back to the original post question.

RN2B73 · May 17, 2008

Run a search on the topic here on Allnurses, or just look back at some older NICU threads. There have been several on the topic.
Now, back to the original post question.

Thanks... I think? :uhoh21:

dawngloves, BSN, RN · May 17, 2008

What is his intake per kilo?

preemiex2 · May 19, 2008

Are you able to get donor milk at your NICU? We use donor milk frequently in our NICU and it comes in 20cal and 24cal concentrations. The mother has to sign a release and it is then billed to the insurance company per container. Each container if 90mls. We just document the batch # and amount along with the patient med rec # so billing can send it to insurance. As far as fortifiers, we only use Enfamil and Similac HMF so I can't advise on the Prolacta but it would be worth a shot if you could trial it. It would think the 24cal DBM could help this little one if nothing else is successful in putting weight on them.

One more suggestion, have you tried any MCT oil at all? I'm sure it they aren't tolerating fortifiers or elemental formulas that MCT would be a stretch but just in case....

sunny17 · May 20, 2008

Are you able to get donor milk at your NICU? We use donor milk frequently in our NICU and it comes in 20cal and 24cal concentrations. The mother has to sign a release and it is then billed to the insurance company per container. Each container if 90mls. We just document the batch # and amount along with the patient med rec # so billing can send it to insurance. As far as fortifiers, we only use Enfamil and Similac HMF so I can't advise on the Prolacta but it would be worth a shot if you could trial it. It would think the 24cal DBM could help this little one if nothing else is successful in putting weight on them.
One more suggestion, have you tried any MCT oil at all? I'm sure it they aren't tolerating fortifiers or elemental formulas that MCT would be a stretch but just in case....

The prolacta product is donor milk which is calculate for caloric content and added to the mother's milk, 80cc-mother's milk and 20 cc of prolacta, so we will see how this goes! We also reviewed the mother's diet and found that she has been eating very little fat, she is currently trying to eat a more protein-good fat diet in hope's of bumping up the caloric content. I really wish we had a cream-a-crit, then we could test her milk on a daily basis. We have not used MCT oil...but I would be afraid she would not tolerate that as well.

Cross our fingers this works!!

Thanks!