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?

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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?

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5 comments to Three Things You Should Know About “Fortified Breast Milk”

  • Anonymous

    (This is guaranteed laughs in the Chinese classroom. It was from the beginning a particle in a Pink Panther flick picture show).

    A servant walks into a boutique and sees a beautiful bantam dog. He asks the shopkeeper, "Does your dog bite?"
    The shopkeeper says, "No, my dog does not bite."
    The people tries to pet the dog and the dog bites him.
    "Ouch!" He says, "I brainstorm you said your dog does not snack!"
    The shopkeeper replies, "That is not my dog!"
    Submitted by Rick Bell

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  • I’m tiny myself so they ended up putting 3 PACKS of fortifier for each 50cc in my milk… then right before we left they checked my cal count…. My milk is naturally 31.5k/oz! HA! He is lactose intolerant (so is my hubby) but other than that he is eating a normal 1yr old diet! :D

    • So happy to read that he’s eating a normal, healthy diet! That’s fabulous! When I had my 3rd baby, the nurses all commented on how “rich” my milk was. I really had no idea, but it got the job done. ;)

  • My niece (born at 25 weeks) had to have some fortified breast milk twice a week, when she was brought home, but they found that when she choked on it and ended up with pneumonia related to it, the doctor ended up telling my sister to just nurse her and up her own calories, with healthy fats etc. to make it more rich. She also pumped off a little of the foremilk and then let her nurse. She started pretty much completely breastfeeding at 36 weeks.

    • It always makes me so happy to read about micropreemies who were able to successfully nurse… how wonderful! That was something I never achieved with my micropreemie, but I was happy to be able to provide her with pumped milk for her first year. :)

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