Fortifying BM with formula

Hi guys,

I'm not sure where to post this so I hope I've got the right place.

I've been consulting with a paediatric dietician due to my DS (9mnths) having poor weight gains which are slower each month and has led to a continual plummet through the percentiles. It seems he is burning up my calories than his appetite caters for. We have a bit of plan to increase his calorie intake both with his solids and with his milk.

The dietician recommended that I mix some formula into his BM. I'm an EE so this is easily achievable but I'm finding that the formula sits at the bottom rather than mixes in. I'm slightly warming the BM prior to mixing in the formula. It sort of sits at the bottom and I try mixing it by gently swirling so I don't break down the BM. I then trying warming it to my DS taste and gently swirling again but it still sits at the bottom. I just hope enough is mixing in so that he is getting some more calories.

Has enough one else had to fortify their BM and how have you been able to get the formula powder dissolve?

Thanks

Lisa - we had a previous thread about this a long time ago. There is a special "human milk fortifier" which is better for mixing with BM than normal formula.


Have you tried putting the formula with a smaller amount of BM and shaking the living heck out of it and then adding it to the rest of the BM?

Personally I'd forget about the formula and just give extra solids and foods high in good fats like avocado. Not sure but why have his weights been? My DD was 7kg at 8mths and at 11mths she is still at 7kg hasn't gained any weight but there is no concern as she still looks happy and healthy. How old is your DS? Because when babies start to get more active there weight gains become slower.

Is he otherwise well? Any health issues? Any family history of allergies/intolerances? (or have you covered all this with the doc :)) I presume since you're seeing a paed and still weighing regularly then you've some other reason to be particularly concerned?
Sometimes, it's not just a matter of more calories. Sometimes there's something else going on. Sometimes it's just the way they are.
How's he going with solids?

Kmn - thanks for the suggestion it worked, it goes against everything in me to shake it but I guess a small amount shaken won't hurt.

Em - my DS has a milk protein allergy so it's hard to give healthy foods that are high in calories. He doesn't like avocado and most soy replacements are lower in fat than the dairy version. I have to use oils and nuttelex in his food. I'm also looking into a few more things like soy cheese and cream etc. I guess fortification with formula is suggested because I can easily do it as a full time expresser. Unfortunately we are using the soy formula which I feel mixed about. DS won't take the prescription formula. I don't think the soy formula is a long term plan as the paed think he will outgrow his milk allergy maybe even by 12 months. At least he is getting BM as his primary milk.

MadB - Yes he is otherwise well, I think. We are just waiting on one more test result to come in from his poo sample. Yes there is a history of coeliacs and lactose intolerance which is all under check by the paed. DS has a milk protein allergy. The main concern is the continual slowing of his weight. If he keeps slowing down he will be off the charts soon as he is on the 10th percentile. The 10th is not so much a matter of concern, it;s that he is continuing to slow so if the pattern continues he will be off the charts. Solids - he is very fussy and is a bit hit and miss if he feeds or not.

I guess i'm a bit of an interventionist and would rather he have a tiny bit more weight, or at least hold himself on the centile curve, even if it's at a low point. I was a very sick and underweight child (different issues) and I just don't want this to happen to him. I know I'm probably projecting my own issues. We are also about to start childcare and I dread him getting gastro as he just doesn't have much on him to lose so I'm agreeable to the dietary plan. I particularly like that I don't have to stop giving him BM and no one has suggested it.

Has he been tested for coeliacs? With a family history and history of low weight gain once solids are introduced there is strong indication for testing
It seems to me that it would be important to get to the route of the problem rather than just t resort to formula.

I can recommend an LC who is a dietician she is in Perth but consults via phone and Skype if you are interested

Yes my son has been tested for coeliacs. He holds the gene but the antibody test has come back negative at this stage. The paediatrician has ran a battery of tests over two occasions and nothing has come back. He is a very active bub and the most likely explanation is that as well as coming from thin parents he is more active than his appetite is catering for.