How to fortify breast milk to 24 calories with neosure

Preparing and Storing Human Milk Fortified with Powder Formula

Narrator: Your child receives human milk that is prepared with formula to meet their nutrition needs. Human milk calorie concentration varies and is about 20 calories per ounce. Your healthcare provider has prescribed a higher caloric density human milk for your child which is made by adding formula powder to human milk. Your child's health depends on following these instructions. This video will take you through the steps to properly fortify human milk.

Wash your hands and get your supplies ready. You will need expressed breast milk, a container of powder formula, a teaspoon from a measuring spoon set, a bottle and mixing instructions provided by a healthcare professional. Check the use by date on the formula can to make sure the formula has not expired.

Next, get your human milk ready. Pour the desired amount of human milk into a bottle or container. The amount will be based on the mixing instructions provided by a healthcare professional.

Next, get ready to add powdered formula to the human milk. Do not use the scoop found in the can of formula; instead use a teaspoon from a measuring spoon set to measure a level teaspoon of formula powder. Add the desired number of teaspoons of formula to the human milk. The amount will be based on the mixing instructions provided by a healthcare professional.

Finally, mix the human milk and formula together. This can be done by closing the bottle and shaking until well-mixed, about 10 to 15 seconds. Once human milk is fortified, feed your child immediately or cover and store in the refrigerator to prevent growth of bacteria. Throw out any unused fortified human milk 24 hours after preparation. Discard any fortified human milk that is still in the bottle 1 hour after the start of a bottle feeding or has been out of the refrigerator for more than 4 hours when given by feeding tube.

Normal breast milk or formula usually has 20 calories per ounce. Most babies do well on regular breast milk or formula. Your baby may need high calorie breast milk or formula if she is smaller than normal or gains less weight than expected.

Do not give your baby high calorie milk or formula unless your healthcare provider tells you to do so. It may cause health problems if your baby can’t digest it properly.

High calorie milk may be 22 or 24 calories per ounce. It depends on how many calories your baby needs. You can make high calorie milk using formula or pumped breast milk.

Some formulas are made just for premature infants. These are called premature follow-up formulas. They have extra calories when you follow package directions. These formulas should not be used by babies who were full-term. You do not need to use a special premature formula to fix high-calorie breast milk for a premature baby. Regular formula works fine.

Measure carefully when making high-calorie formula. Use a special measuring spoon to make sure you get the right dose. The average household teaspoon may not hold the right amount.

Breast-Fed Babies (Full-Term and Premature)

To make 22-calorie per ounce breast milk:

Add 1/2 teaspoon of regular formula powder to 3 ounces (89 mL) of pumped breast milk.

To make 24-calorie per ounce breast milk:

Add 1 teaspoon of regular formula powder to 3 ounces (89 mL) of pumped breast milk.

Formula-Fed Full-Term Babies

To make 22-calorie per ounce formula (starting from powder that normally makes 20-calorie per ounce):

If you have the concentrated liquid formula, mix 5.5 ounces (163 mL) of formula with 4.5 ounces (133 mL) of water.

If you have the powder formula, mix 3 scoops of powder with 5.5 ounces (163 mL) of water.

To make 24-calorie per ounce formula:

If you have the concentrated liquid formula, mix 3 ounces (89 mL) of formula for 2 ounces (59 mL) of water.

If you have the powder formula, mix 3 scoops of powder with 5 ounces (148 mL) of water.

Formula-Fed Premature Babies

Your provider may suggest that you use a special premature follow-up formula. You can buy these products at the store.

To make 22-calorie per ounce formula:

Mix 2 scoops of premature follow-up formula with 4 ounces (118 mL) of water.

To make 24-calorie per ounce formula:

Mix 2 scoops of premature follow-up formula with 3 1/2 ounces (104 mL) of water.

Do not add sugar, honey, or any other sweetener to the milk or formula. Never give honey to babies. Honey may cause a serious disease called botulism in children less than 1 year old.

Discard bottles of formula left out of the refrigerator for 1 hour or more. Throw away any refrigerated formula after 24 hours.

Call your healthcare provider if:

• You have questions about how to fix formula for your baby.
• Your baby is not growing even with the 24-calorie per ounce formula.

Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado.

Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2014-10-23
Last reviewed: 2014-10-16

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

Can I mix Similac NeoSure with breast milk?

How do you make Similac NeoSure 24 calories?

How do you fortify 24 calories of breastmilk?

Can you use formula to fortify breast milk?