Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006  Greetings, I spoke with my son's nurse last night in the NICU at Washington Hospital Center (he's 30 weeks today, yeah!) who said that rarely are exclusively breastfed premies able to gain the weight they need to go home because "breastmilk simply does not have enough calories." He said most babies will require Enfamil's Human Milk Fortifier. Now I'm all for doing whatever needs to be done to get my baby home healthy, but I'm thinking.....Enfamily has the nursery on "lock down." Every product that I've been given from the diaper bags to the bottles that I use to pump my milk into are made by Enfamil. Is there a conflict of interest here? The nurse was honest enough to tell us that all of their "studies" are based on the use of Human Milk Fortifiers and they have not done any studies on premies who were exclusively breastfed and whether or not they have growth issues. My problem with this is that my husband and I are both lactose intolerant AND my husband has severe allergies AND eczema. The last thing I believe my premature baby needs is some cow's milk. Now, if this product is harmless and my worries unfounded, I'd like to know that too. What are my alternatives? Who should I talk to? I'm going to request a meeting with my son's doctor, but I want to be armed with the right information. Here's the product: Enfamil® Human Milk Fortifier Nutritional Supplement To Be Added To Breast Milk For Premature and Low-birth-weight Infants DescriptionEnfamil® Human Milk Fortifier is to be added to breast milk for feeding premature and low-birth-weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother’s milk. Enfamil Human Milk Fortifier is milk-based and, when mixed with mother’s milk, increases the levels of protein, energy, calcium, phosphorus, and other nutrients, producing a diet more suited to the nutritional needs of the rapidly growing premature infant. Product Features Well tolerated 1.1 g protein/4 packets Added iron to reduce the need for additional iron supplementation Includes fat and essential fatty acids Low osmolalityIndicationsEnfamil® Human Milk Fortifier is designed for premature infants as a nutritional supplement to be added to mother’s milk.CautionNot nutritionally complete. To be used only under the supervision of a physician. Nutrients* Per 4–0.025 oz(0.71 g) Packets Protein, g 1.1 Fat, g 1 Linoleic acid, mg 140 Carbohydrate, g < 0.40 Vitamins/Other Nutrients Vitamin A, IU 950 Vitamin D, IU 150 Vitamin E, IU 4.6 Vitamin K, µg 4.4 Thiamin (Vitamin B1), µg 150 Riboflavin (Vitamin B2), µg 220 Vitamin B6, µg 115 Vitamin B12, µg 0.18 Niacin, µg 3000 Folic acid (folacin), µg 25 Pantothenic acid, µg 730 Biotin, µg 2.7 Vitamin C (ascorbic acid), mg 12 Minerals Calcium, mg 90 Phosphorus, mg 50 Magnesium, mg 1 Iron, mg 1.44 Zinc, mg 0.72 Manganese, µg 10 Copper, µg 44 Sodium, mg 16 Potassium, mg 29 Chloride, mg 13 * Product nutrient values and ingredients are subject to change. Please see product label for current information.Nutrient Facts Nutrient Density Per 4 packets Protein (% Calories) 32 Fat (% Calories) 63 Carbohydrate (% Calories) 5 Potential Renal Solute Load (mOsm/100 Calories)†70 Potential Renal Solute Load (mOsm/100 mL)†9.7 per 4 packets‡ Osmolality (mOsm/kg water)§ +35 Osmolarity (mOsm/L)§ Not available Gluten-Free Yes Lactose-Free No Galactose-Free No †Fomon SJ, Ziegler EE. Renal solute load and potential renal solute load in infancy. J Pediatr. 1999;134:11-14. ‡ 23 mOsm/102 mL when 4 packets added to 100 mL preterm human milk. § When added to human milk as recommended, EHMF increases osmolality by approximately 35 mOsm/kg water.Product CharacteristicsFatEnfamil® Human Milk Fortifier provides 1 g fat/4 packets. The fat blend is 70% MCT oil for excellent absorption and 30% soy oil to provide the essential fatty acids, linoleic acid and alpha-linolenic acid. Including fat in the formulation of Enfamil Human Milk Fortifier results in lower increases in osmolality when the product is mixed with human milk.ProteinEnfamil Human Milk Fortifier provides 1.1 g protein/4 packets to help meet the rapid growth needs of very-low-birth-weight and premature infants. The protein sources are milk protein isolate and whey protein isolate hydrolysate, and the whey:casein ratio is 60:40.CarbohydrateThe carbohydrate content of Enfamil Human Milk Fortifier is <0.4 g/4 packets. Carbohydrates from mineral sources and corn syrup solids are the sources of carbohydrate. The low carbohydrate content helps keep the osmolality of the fortified human milk feeding low.Vitamins and MineralsVitamin and mineral levels are designed to meet recent expert recommendations for preterm infants.1-4Calcium and PhosphorusEnfamil Human Milk Fortifier provides 90 mg calcium/4 packets, 50 mg of phosphorus/4 packets, and has a calcium:phosphorus ratio of about 1.8:1. The low-birth-weight infant requires greater amounts of calcium to meet dietary requirements than is provided by human milk.5IronEnfamil Human Milk Fortifier provides 1.44 mg iron/4 packets. Iron supplementation of Enfamil Human Milk Fortifier reduces the need for additional iron supplementation so there is less need for nurse intervention. It also avoids hyperosmolar stresses caused by separate iron supplementation. Recent research found that enteral iron supplementation is feasible in preterm infants weighing less than 1301 g even when started as soon as enteral feeding is tolerated.6 The researchers concluded that enteral iron in combination with sufficient protein intake may reduce the incidence of iron deficiency.Electrolytes—Sodium, Potassium, and ChlorideThe sodium, potassium, and chloride levels are 16 mg/4 packets, 29 mg/4 packets, and 13 mg/4 packets, respectively.Clinical ExperienceEnfamil Human Milk Fortifier was first introduced in 1984. Four abstract presentations7-10 and four published articles document the growth, nutrient status, and bone mineralization of infants fed the original formulation.11-14The product was reformulated in the late 1980s to provide higher calcium and phosphorous levels. Research showed that very-low-birth-weight infants receiving this formulation achieved intrauterine accretion rates for calcium and phosphorus.15 In addition, a later study showed that infants fed predominantly human milk fortified with Enfamil Human Milk Fortifier maintained adequate nutritional status without compromising host defense or feeding tolerance.16 These infants also differed from premature formula-fed infants in several outcome measures: lower morbidity from necrotizing enterocolitis and late onset sepsis, slower rates of weight gain and length increase, and earlier hospital discharge (despite slower weight gain). The researchers concluded that fortified human milk feeding should be endorsed in all neonatal nurseries.16 These investigators also evaluated feeding tolerance and concluded that the addition of Enfamil Human Milk Fortifier did not affect feeding tolerance.17In 2002, Enfamil Human Milk Fortifier was reformulated with a higher protein level, lower carbohydrate level, and increased fat level than found in the formulations used in the studies discussed above. Minor adjustments in some vitamins and minerals were also made. This formulation was evaluated in a randomized, prospective, double-blind clinical trial.18 Preterm infants who were born at 33 weeks gestation were assigned to receive either their mothers’ milk supplemented with reformulated Enfamil Human Milk Fortifier or another commercial human milk fortifier. Growth and safety outcomes were similar between the two groups. The investigators concluded that reformulated Enfamil Human Milk Fortifier promoted growth comparable to that of the other commercial human milk fortifier and there was no difference in safety.CompositionIngredients: Medium chain triglycerides (MCT oil), milk protein isolate, whey protein isolate hydrolysate, soybean oil, calcium phosphate, calcium glycerophosphate, calcium gluconate, and less than 2% corn syrup solids, soy lecithin, vitamin A palmitate, vitamin D3, vitamin E acetate, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, ascorbic acid, magnesium phosphate, potassium phosphate, ferrous sulfate, zinc sulfate, cupric sulfate, sodium citrate, potassium chloride, potassium citrate. ***************************************Monica Z. UtseyPresidentSouthern DC Mocha Momswww.southerndcmochamoms.com202-484-5680 **********************Utsey Enterprises, LLCWe Create:Conference novelties, t-shirts, uniforms & more!www.utseyenterprises.com**********************You are not an African because you are born in Africa. You are an African because Africa is born in you.-Marimba Ani Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 Asking ourselves questions can be as important as asking a doctor questions...One question might be how has preemie babies survived for ages w/out Enfamil?...Who is cow milk tolerant? Gaining the weight slower is fine (except for maybe the insurance companies that pay for the longer hospital stay)...Follow you heart, and follow the money tral. Mark "Monica Utsey" <zionismyjoy To: "AABA-DC" <AABA-DC >,"BellyDancingSisters" <BellyDancingSisters >,"" CC: "Dawn Covin" <dawn8192k,"Claudia Booker" <DCBirthingHands,<dawn human milk fortifier and breastmilkTue, 9 May 2006 09:28:21 -0400 Greetings, I spoke with my son's nurse last night in the NICU at Washington Hospital Center (he's 30 weeks today, yeah!) who said that rarely are exclusively breastfed premies able to gain the weight they need to go home because "breastmilk simply does not have enough calories." He said most babies will require Enfamil's Human Milk Fortifier. Now I'm all for doing whatever needs to be done to get my baby home healthy, but I'm thinking.....Enfamily has the nursery on "lock down." Every product that I've been given from the diaper bags to the bottles that I use to pump my milk into are made by Enfamil. Is there a conflict of interest here? The nurse was honest enough to tell us that all of their "studies" are based on the use of Human Milk Fortifiers and they have not done any studies on premies who were exclusively breastfed and whether or not they have growth issues. My problem with this is that my husband and I are both lactose intolerant AND my husband has severe allergies AND eczema. The last thing I believe my premature baby needs is some cow's milk. Now, if this product is harmless and my worries unfounded, I'd like to know that too. What are my alternatives? Who should I talk to? I'm going to request a meeting with my son's doctor, but I want to be armed with the right information. Here's the product: Enfamil® Human Milk Fortifier Nutritional Supplement To Be Added To Breast Milk For Premature and Low-birth-weight Infants DescriptionEnfamil® Human Milk Fortifier is to be added to breast milk for feeding premature and low-birth-weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother’s milk. Enfamil Human Milk Fortifier is milk-based and, when mixed with mother’s milk, increases the levels of protein, energy, calcium, phosphorus, and other nutrients, producing a diet more suited to the nutritional needs of the rapidly growing premature infant. Product Features Well tolerated 1.1 g protein/4 packets Added iron to reduce the need for additional iron supplementation Includes fat and essential fatty acids Low osmolalityIndicationsEnfamil® Human Milk Fortifier is designed for premature infants as a nutritional supplement to be added to mother’s milk.CautionNot nutritionally complete. To be used only under the supervision of a physician. Nutrients* Per 4–0.025 oz(0.71 g) Packets Protein, g 1.1 Fat, g 1 Linoleic acid, mg 140 Carbohydrate, g < 0.40 Vitamins/Other Nutrients Vitamin A, IU 950 Vitamin D, IU 150 Vitamin E, IU 4.6 Vitamin K, µg 4.4 Thiamin (Vitamin B1), µg 150 Riboflavin (Vitamin B2), µg 220 Vitamin B6, µg 115 Vitamin B12, µg 0.18 Niacin, µg 3000 Folic acid (folacin), µg 25 Pantothenic acid, µg 730 Biotin, µg 2.7 Vitamin C (ascorbic acid), mg 12 Minerals Calcium, mg 90 Phosphorus, mg 50 Magnesium, mg 1 Iron, mg 1.44 Zinc, mg 0.72 Manganese, µg 10 Copper, µg 44 Sodium, mg 16 Potassium, mg 29 Chloride, mg 13 * Product nutrient values and ingredients are subject to change. Please see product label for current information.Nutrient Facts Nutrient Density Per 4 packets Protein (% Calories) 32 Fat (% Calories) 63 Carbohydrate (% Calories) 5 Potential Renal Solute Load (mOsm/100 Calories)†70 Potential Renal Solute Load (mOsm/100 mL)†9.7 per 4 packets‡ Osmolality (mOsm/kg water)§ +35 Osmolarity (mOsm/L)§ Not available Gluten-Free Yes Lactose-Free No Galactose-Free No †Fomon SJ, Ziegler EE. Renal solute load and potential renal solute load in infancy. J Pediatr. 1999;134:11-14. ‡ 23 mOsm/102 mL when 4 packets added to 100 mL preterm human milk. § When added to human milk as recommended, EHMF increases osmolality by approximately 35 mOsm/kg water.Product CharacteristicsFatEnfamil® Human Milk Fortifier provides 1 g fat/4 packets. The fat blend is 70% MCT oil for excellent absorption and 30% soy oil to provide the essential fatty acids, linoleic acid and alpha-linolenic acid. Including fat in the formulation of Enfamil Human Milk Fortifier results in lower increases in osmolality when the product is mixed with human milk.ProteinEnfamil Human Milk Fortifier provides 1.1 g protein/4 packets to help meet the rapid growth needs of very-low-birth-weight and premature infants. The protein sources are milk protein isolate and whey protein isolate hydrolysate, and the whey:casein ratio is 60:40.CarbohydrateThe carbohydrate content of Enfamil Human Milk Fortifier is <0.4 g/4 packets. Carbohydrates from mineral sources and corn syrup solids are the sources of carbohydrate. The low carbohydrate content helps keep the osmolality of the fortified human milk feeding low.Vitamins and MineralsVitamin and mineral levels are designed to meet recent expert recommendations for preterm infants.1-4Calcium and PhosphorusEnfamil Human Milk Fortifier provides 90 mg calcium/4 packets, 50 mg of phosphorus/4 packets, and has a calcium:phosphorus ratio of about 1.8:1. The low-birth-weight infant requires greater amounts of calcium to meet dietary requirements than is provided by human milk.5IronEnfamil Human Milk Fortifier provides 1.44 mg iron/4 packets. Iron supplementation of Enfamil Human Milk Fortifier reduces the need for additional iron supplementation so there is less need for nurse intervention. It also avoids hyperosmolar stresses caused by separate iron supplementation. Recent research found that enteral iron supplementation is feasible in preterm infants weighing less than 1301 g even when started as soon as enteral feeding is tolerated.6 The researchers concluded that enteral iron in combination with sufficient protein intake may reduce the incidence of iron deficiency.Electrolytes—Sodium, Potassium, and ChlorideThe sodium, potassium, and chloride levels are 16 mg/4 packets, 29 mg/4 packets, and 13 mg/4 packets, respectively.Clinical ExperienceEnfamil Human Milk Fortifier was first introduced in 1984. Four abstract presentations7-10 and four published articles document the growth, nutrient status, and bone mineralization of infants fed the original formulation.11-14The product was reformulated in the late 1980s to provide higher calcium and phosphorous levels. Research showed that very-low-birth-weight infants receiving this formulation achieved intrauterine accretion rates for calcium and phosphorus.15 In addition, a later study showed that infants fed predominantly human milk fortified with Enfamil Human Milk Fortifier maintained adequate nutritional status without compromising host defense or feeding tolerance.16 These infants also differed from premature formula-fed infants in several outcome measures: lower morbidity from necrotizing enterocolitis and late onset sepsis, slower rates of weight gain and length increase, and earlier hospital discharge (despite slower weight gain). The researchers concluded that fortified human milk feeding should be endorsed in all neonatal nurseries.16 These investigators also evaluated feeding tolerance and concluded that the addition of Enfamil Human Milk Fortifier did not affect feeding tolerance.17In 2002, Enfamil Human Milk Fortifier was reformulated with a higher protein level, lower carbohydrate level, and increased fat level than found in the formulations used in the studies discussed above. Minor adjustments in some vitamins and minerals were also made. This formulation was evaluated in a randomized, prospective, double-blind clinical trial.18 Preterm infants who were born at 33 weeks gestation were assigned to receive either their mothers’ milk supplemented with reformulated Enfamil Human Milk Fortifier or another commercial human milk fortifier. Growth and safety outcomes were similar between the two groups. The investigators concluded that reformulated Enfamil Human Milk Fortifier promoted growth comparable to that of the other commercial human milk fortifier and there was no difference in safety.CompositionIngredients: Medium chain triglycerides (MCT oil), milk protein isolate, whey protein isolate hydrolysate, soybean oil, calcium phosphate, calcium glycerophosphate, calcium gluconate, and less than 2% corn syrup solids, soy lecithin, vitamin A palmitate, vitamin D3, vitamin E acetate, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, ascorbic acid, magnesium phosphate, potassium phosphate, ferrous sulfate, zinc sulfate, cupric sulfate, sodium citrate, potassium chloride, potassium citrate. ***************************************Monica Z. UtseyPresidentSouthern DC Mocha Momswww.southerndcmochamoms.com202-484-5680 **********************Utsey Enterprises, LLCWe Create:Conference novelties, t-shirts, uniforms & more!www.utseyenterprises.com**********************You are not an African because you are born in Africa. You are an African because Africa is born in you.-Marimba Ani Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 Hi Monica, Both my boys were premature. I pumped and wanted to just do breast milk, but I got the same thing from the nurses. I ended up letting them use a few feedings a day of their choice and the rest was breast. I figured I was willing to give a little on that cause the sooner I could get them home the better. I still think that all breast is best and that the jaundice mine both had was as much due to the formula as to their livers being undeveloped, but that's just my theory - you have to follow your heart after weighing all sides. N. Nancy Parlette HEALTHY LIVING STRATEGIES Natural Health Counselor Nutrition Educator ENERGIZING YOU FOR LIVING! (410) 531-2410 http://www.healthylivingstrategies.net/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2006 Report Share Posted May 9, 2006 Hi Monica, Good job sticking to your guns (or should I say your breasts) on this one! Technology is a wonderful thing. You have this beautiful baby that would not have made it otherwise. However, I believe that nothing can replace real food or real breast milk. If I take supplements I never take anything synthetic, the body cannot process it. Now, we are also talking about the healthy life of your child. You should look inside, ask your gut if this is an ok choice for you and your baby. Perhaps using half the dose would be ok. Or some combination of every other feeding, or once every other day. It's your child and you get to make the decisions. I also suggest contacting Dr. Gabriel Cousens at The Tree of Life Rejuvination Center ( www.treeoflife.nu ). As far as I can tell, he has the most information on raw children, raw pregnancy. Tree of Life Main OfficeToll Free: 866-394-2520 520-394-2520 Additionally, if you are open to it, I can also recommend a good medical intuit to do a reading for your situation. To you and your baby's health! Paula Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2006 Report Share Posted May 11, 2006 greetings i concur with the group as to making sure that you go with your gut feelings, also make sure that you are drinking plenty of fluids and fresh juices and herbal teas to ensure that your breast milk is the healthiest that it can be. also is the baby gaining weight? at all, i know with my children, when breastfeeding the weight gain of breast fed children is not going to be as great as that of children taking artificial enhancers, and they will almost always give you the blues when dealing with mainstream hospitals and doctors keep the faith peace belit Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2006 Report Share Posted May 20, 2006 Monaca, I'm not sure of the additional nutritional needs of premies, but I do have a 2 month old who had latching on issues the first 2 weeks and lost 2 pounds. The result was my breast milk supply decreased and I had to build up again. I had to supplement with formula slightly until I got my supply back up and we used a bottle until he started latching on better. It took us 2 weeks to get my supply back up and 4 weeks to have him latch on great. Now his is 13 lbs. and growing strong. I fed him every 2 hours to get his weight back up for the 1st week and then as he demanded after that, which was about 2 to 3 hours. Formula fills babies up more and there may be larger gaps in between. My advice, is use the supplement/ fortifier temporarily if your baby needs it. However, breast milk is the perfect food for your baby – premature infants or full term. Your colostrum is perfectly formulated for your baby. There is no commercial food like it and your baby needs this especially as a premie. It has infection fighting proteins and antibodies. In the " Womanly Art of Breastfeeding " this is what it says about breast milk and premies. " Human milk is easy for your baby to digest; premature babies use the fats and proteins in human milk more efficiently than those in formulas. Studies have shown that human milk enhances brain development in premies. " The more breast milk he has the better he'll do. If on breast milk alone he seems to not be gaining weight fast enough, then maybe supplementing ok. Stay in tune with your baby, watch his bowl movements, urinations, and weight everyday. You will soon be able to tell when something is not going well. The best way to have the baby gain weight from breast feeding is to feed him every 2 hours. This is hard work, especially if he is in the hospital, but it is worth it and it worked for me and my baby. Pump and have the hospital feed him the pumped milk every 2 hours. Also your baby is what you eat. If your baby needs something you need to eat it. I have this great vegetarian DHA. You can get it on www.NaturalZing.com. Do be very careful that you do not lessen your supply. If you use a supplement, you'll need to pump as if the baby fed from you. Drink " Mother's Milk " Tea, there is a herbal extract called " Mother's Lactation tonic " , and vcaps of Fenugreek seed. Feel free to contact me if you need emotional support. These things take time and persistence. It's like 2 steps forward, one step back. Slow steady progress is progress. I wish you and your baby many blessings and abundant health. And congratulations! Littleveggiemom Littleveggiemom , " Monica Utsey " <zionismyjoy wrote: > > Greetings, > I spoke with my son's nurse last night in the NICU at Washington Hospital Center (he's 30 weeks today, yeah!) who said that rarely are exclusively breastfed premies able to gain the weight they need to go home because " breastmilk simply does not have enough calories. " He said most babies will require Enfamil's Human Milk Fortifier. Now I'm all for doing whatever needs to be done to get my baby home healthy, but I'm thinking.....Enfamily has the nursery on " lock down. " Every product that I've been given from the diaper bags to the bottles that I use to pump my milk into are made by Enfamil. Is there a conflict of interest here? The nurse was honest enough to tell us that all of their " studies " are based on the use of Human Milk Fortifiers and they have not done any studies on premies who were exclusively breastfed and whether or not they have growth issues. My problem with this is that my husband and I are both lactose intolerant AND my husband has severe allergies AND eczema. The last thing I believe my premature baby needs is some cow's milk. Now, if this product is harmless and my worries unfounded, I'd like to know that too. What are my alternatives? Who should I talk to? I'm going to request a meeting with my son's doctor, but I want to be armed with the right information. Here's the product: > > Enfamil® Human Milk Fortifier > > Nutritional Supplement To Be Added To Breast Milk For Premature and Low-birth-weight Infants > > > Description<> > Enfamil® Human Milk Fortifier is to be added to breast milk for feeding premature and low-birth-weight infants. It provides enriched nutrition needed by these special babies while still allowing them to receive their mother’s milk. Enfamil Human Milk Fortifier is milk-based and, when mixed with mother’s milk, increases the levels of protein, energy, calcium, phosphorus, and other nutrients, producing a diet more suited to the nutritional needs of the rapidly growing premature infant. > > Product Features<> > Well tolerated > 1.1 g protein/4 packets > Added iron to reduce the need for additional iron supplementation > Includes fat and essential fatty acids > Low osmolality > > Indications<> > Enfamil® Human Milk Fortifier is designed for premature infants as a nutritional supplement to be added to mother’s milk. > > Caution > Not nutritionally complete. To be used only under the supervision of a physician. > > Nutrients<>* > > Per 4†" 0.025 oz > (0.71 g) Packets > Protein, g 1.1 > Fat, g 1 > Linoleic acid, mg 140 > Carbohydrate, g < 0.40 > Vitamins/Other Nutrients > Vitamin A, IU 950 > Vitamin D, IU 150 > Vitamin E, IU 4.6 > Vitamin K, µg 4.4 > Thiamin (Vitamin B1), µg 150 > Riboflavin (Vitamin B2), µg 220 > Vitamin B6, µg 115 > Vitamin B12, µg 0.18 > Niacin, µg 3000 > Folic acid (folacin), µg 25 > Pantothenic acid, µg 730 > Biotin, µg 2.7 > Vitamin C (ascorbic acid), mg 12 > Minerals > Calcium, mg 90 > Phosphorus, mg 50 > Magnesium, mg 1 > Iron, mg 1.44 > Zinc, mg 0.72 > Manganese, µg 10 > Copper, µg 44 > Sodium, mg 16 > Potassium, mg 29 > Chloride, mg 13 > * Product nutrient values and ingredients are subject to change. Please see product label for current information. > > Nutrient<> Facts Nutrient Density Per 4 packets > Protein (% Calories) 32 > Fat (% Calories) 63 > Carbohydrate (% Calories) 5 > Potential Renal Solute Load (mOsm/100 Calories)†70 > Potential Renal Solute Load (mOsm/100 mL)†9.7 per 4 packets‡ > Osmolality (mOsm/kg water)§ +35 > Osmolarity (mOsm/L)§ Not available > Gluten-Free Yes > Lactose-Free No > Galactose-Free No > †Fomon SJ, Ziegler EE. Renal solute load and potential renal solute load in infancy. J Pediatr. 1999;134:11-14. > ‡ 23 mOsm/102 mL when 4 packets added to 100 mL preterm human milk. > § When added to human milk as recommended, EHMF increases osmolality by approximately 35 mOsm/kg water. > > Product<> Characteristics > Fat > Enfamil® Human Milk Fortifier provides 1 g fat/4 packets. The fat blend is 70% MCT oil for excellent absorption and 30% soy oil to provide the essential fatty acids, linoleic acid and alpha- linolenic acid. Including fat in the formulation of Enfamil Human Milk Fortifier results in lower increases in osmolality when the product is mixed with human milk. > > Protein > Enfamil Human Milk Fortifier provides 1.1 g protein/4 packets to help meet the rapid growth needs of very-low-birth-weight and premature infants. The protein sources are milk protein isolate and whey protein isolate hydrolysate, and the whey:casein ratio is 60:40. > > Carbohydrate > The carbohydrate content of Enfamil Human Milk Fortifier is <0.4 g/4 packets. Carbohydrates from mineral sources and corn syrup solids are the sources of carbohydrate. The low carbohydrate content helps keep the osmolality of the fortified human milk feeding low. > > Vitamins and Minerals > Vitamin and mineral levels are designed to meet recent expert recommendations for preterm infants.1-4 > > Calcium and Phosphorus > Enfamil Human Milk Fortifier provides 90 mg calcium/4 packets, 50 mg of phosphorus/4 packets, and has a calcium:phosphorus ratio of about 1.8:1. The low-birth-weight infant requires greater amounts of calcium to meet dietary requirements than is provided by human milk.5 > > Iron > Enfamil Human Milk Fortifier provides 1.44 mg iron/4 packets. Iron supplementation of Enfamil Human Milk Fortifier reduces the need for additional iron supplementation so there is less need for nurse intervention. It also avoids hyperosmolar stresses caused by separate iron supplementation. Recent research found that enteral iron supplementation is feasible in preterm infants weighing less than 1301 g even when started as soon as enteral feeding is tolerated.6 The researchers concluded that enteral iron in combination with sufficient protein intake may reduce the incidence of iron deficiency. > > Electrolytes†" Sodium, Potassium, and Chloride > The sodium, potassium, and chloride levels are 16 mg/4 packets, 29 mg/4 packets, and 13 mg/4 packets, respectively. > > Clinical<> Experience > Enfamil Human Milk Fortifier was first introduced in 1984. Four abstract presentations7-10 and four published articles document the growth, nutrient status, and bone mineralization of infants fed the original formulation.11-14 > > The product was reformulated in the late 1980s to provide higher calcium and phosphorous levels. Research showed that very-low- birth-weight infants receiving this formulation achieved intrauterine accretion rates for calcium and phosphorus.15 In addition, a later study showed that infants fed predominantly human milk fortified with Enfamil Human Milk Fortifier maintained adequate nutritional status without compromising host defense or feeding tolerance.16 These infants also differed from premature formula-fed infants in several outcome measures: lower morbidity from necrotizing enterocolitis and late onset sepsis, slower rates of weight gain and length increase, and earlier hospital discharge (despite slower weight gain). The researchers concluded that fortified human milk feeding should be endorsed in all neonatal nurseries.16 These investigators also evaluated feeding tolerance and concluded that the addition of Enfamil Human Milk Fortifier did not affect feeding tolerance.17 > > In 2002, Enfamil Human Milk Fortifier was reformulated with a higher protein level, lower carbohydrate level, and increased fat level than found in the formulations used in the studies discussed above. Minor adjustments in some vitamins and minerals were also made. This formulation was evaluated in a randomized, prospective, double-blind clinical trial.18 Preterm infants who were born at 33 weeks gestation were assigned to receive either their mothers’ milk supplemented with reformulated Enfamil Human Milk Fortifier or another commercial human milk fortifier. Growth and safety outcomes were similar between the two groups. The investigators concluded that reformulated Enfamil Human Milk Fortifier promoted growth comparable to that of the other commercial human milk fortifier and there was no difference in safety. > > Composition<> > Ingredients: Medium chain triglycerides (MCT oil), milk protein isolate, whey protein isolate hydrolysate, soybean oil, calcium phosphate, calcium glycerophosphate, calcium gluconate, and less than 2% corn syrup solids, soy lecithin, vitamin A palmitate, vitamin D3, vitamin E acetate, vitamin K1, thiamin hydrochloride, riboflavin, vitamin B6 hydrochloride, vitamin B12, niacinamide, folic acid, calcium pantothenate, biotin, ascorbic acid, magnesium phosphate, potassium phosphate, ferrous sulfate, zinc sulfate, cupric sulfate, sodium citrate, potassium chloride, potassium citrate. > > > *************************************** > Monica Z. Utsey > President > Southern DC Mocha Moms > www.southerndcmochamoms.com<http://www.southerndcmochamoms.com/> > 202-484-5680 > ********************** > Utsey Enterprises, LLC > We Create: > Conference novelties, t-shirts, uniforms & more! > www.utseyenterprises.com<http://www.utseyenterprises.com/> > ********************** > You are not an African because you are born in Africa. You are an African because Africa is born in you. > -Marimba Ani > Quote Link to comment Share on other sites More sharing options...
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