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Highlights from the Conference on Neonatal Nutrition, Baylor College of Medicine (BCM) and Texas Children’s Hospital (TCH), Houston, TX, March 4-7, 2001.
Feeding Hindmilk
Management of Slow Weight Gain in Human Milk-fed Premature Infant.
By: Nancy Hurst, RN, MSN, IBLC, Director of TCH Lactation Department and Mild Bank, Pediatric Instructor, BCM
Despite the benefits of human milk, preterm infants may be at risk for certain nutritional deficiencies. Studies have observed that human-milk fed preterm infants had slower growth rates and inadequate specific nutrient intakes to meet their proportionately greater needs.
Management of slow weight gain in human milk-fed premature infant:
Approach in step-wise manner:
-exogenous fat source
-corn oil 0.5-2 g/kg/d ( bolus )
-protein supplement 0.5-1.5 g/kg/d
-sodium supplement 1-2 mEq/kg/d
-zinc supplement 1-2 mg/kg/d
-correct Ca and P deficit
*When considering hindmilk feeding, know the mother’s pumped milk volume prior to instruction. The mother’s milk volume needs to be approximately twice the 24 hour milk volume required to meet the infant’s needs. The first 2-3 minutes of her pumping are stored and the latter pumping ( hindmilk ) rich in fat is given to the infant.
Present the need for "fortified" milk to the mother in such a way as not to make her feel inadequate. It is not a case of her milk not being adequate enough to meet her infant’s needs,
Reviewed by: Ernesto Valdes, MD