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February 06, 2008


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That Lea Bee - she is good stuff. I adore that woman. I also loathe Dr. C, on principle. WTF??? Yay for using your investigative mom-gut skills.


Whew, I used to think I was good at math but that made my head spin. Good for you (and Lea Bea) for checking up on Dr C, who I, like LJ, also hate on principle.Glad Ellie's starting to fill out a little bit. Hope the follow up appt goes well


I don't think Lou Bea is right, either unless I've made a mistake. ! scoop formula = 40 calories5 oz breastmilk = 100 caloriesTotal = 140 calories. Divide 140/5.25 oz = 26.67 calories per oz.What I think you need to do is use 2 scoops of formula and make it up to 5.75 oz, which I'm assuming will take approx 5 oz of breastmillk again.2 scoops formula = 80 calories5 oz breastmilk = 100 caloriestotal = 180180/5.75 oz = 27.82 calories per oz.Does that help?


Who is Lea Bea?


Now my head aches.


The calculation of one scoop at 40 calories plus 5 ounces of EBM at 100 calories totalling 140 calories divided by 5 ounces comes out to 28 calories per ounce. The problem apparently is that the powder isn't volumeless. You need to use the full 5 ounces of EBM, and then each fifth of the mixture -- each 1.05 ounce -- will contain 28 calories.


It's a question of total calories vs. calories-per-ounce.If you have 5 oz of milk and a scoop of formula, you'll have more total calories but fewer calories-per-ounce.If you have 4 oz of milk and a scoop of formula, you'll have fewer total calories but more calories-per-ounce. It will be more concentrated.So it's actually more a question of which is works better, filling her belly fuller with a lot of milk, or having her try to tolerate the more concentrated stuff. It also depends on how much she'll actually eat!Hope that makes sense!!


(potential assvice from a NICU RN who's passionate about breastfeeding)Maybe this has already been covered, but you can't assume all breastmilk is 20 cal/oz. Calorie content of breastmilk varies throughout the day and throughout the pumping session, the hindmilk being richer and higher calorie. Learned all about this at a breastfeeding conference led by Dr Meier from Rush-Presbyterian St. Luke's Medical Center in Chicago. There they teach their NICU moms to test the creamatocrit (like hematocrit, only with cream) of the milk to find the calorie content of the specific bottle. Think you could get your hands on a creamatocrit machine? Could you fortify hind milk? Nurse Ellie last after her sibs have had their fill? FWIW, when we increase a baby's calories we do so gradually, 2cal/oz at a time. It might help Ellie tolerate her feeds better if you were able to advance gradually, but I realize time is of the essence.I hope some of this is helpful and isn't just a heap of assvice! I really enjoy your blog and reading about your babies. Just thought I'd de-lurk in case it might help.KathyH (keh724 AT yahoo dot com)


Hi There - I've been reading your blog for months now b/c your triplets were due ~ 3 weeks before mine. My husband and I still look forward to checking up on your latest posts. You mentioned in your previous post you didn't know how much it would cost for you to feed your kids on formula every month, and you would fork over $500. For several reasons, I can't breastfeed mine (even though I successfully did w/my first one) and now we're having to buy nasty formula. It has its benefits, but know I'm hoping you can continue giving your kids breastmilk w/your new schedule. Best Regards.


What's really ridiculous is this is the doctor who was insisting that your sweet Ellie was an equation. With her focus on the math, it's crazy that she doesn't make an effort to get it right.The lack of precision in her method is what really bothers me. Her insistence on putting in the formula first and then filling the rest of the way with breast milk is so stupid. The dry formula not only settles but also reduces in volume by almost half once dissolved.So, for instance, a scoop of formula plus 4 3/4 oz. of breast milk would provide exactly 5 oz. at exactly 27 (not 28!) cal./oz., but if you have this data, why add the dry formula first? It's like instructing someone to fill a one-cup measuring cup 1/3 of the way and refusing to allow the perfectly good 1/3 cup measuring cup to be used!If Ellie, to her, is a simple equation, why not first get the equation right and then use it precisely?I think the doctor who was all about the math actually SUCKS AT MATH and was only following some protocol that was taught to her in a math-for-medical-dummies kind of way.I hope today's appointment goes well.

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