NICU - Introduction of Formula

Formula introduction in NICU was not really a decision I made. It was rather a decision made by doctors. However, keeping formula as a supplement post NICU was a decision I made, which I will talk about in a separate entry.

My breastfeeding journey began with pumping. I started to pump every 3 hours (8 times/day), then increased it up to 10 times/day. Eventually, I pumped whenever I could. It was like I was breastfeeding on demand. I also did cluttered pumping sessions in between our morning and evening visits (Clutter pumping is originally clutter feeding which is feeding your baby as long as she needs/wants). During my clutter pumping sessions, milk would stop coming after 13-15 minutes. When I continued pumping, it would start again after like 5 minutes.

Until day 50, D. was fed only with breastmilk. However, breastmilk I gave NICU was mixed with Human Milk Fortifier, which is a nutrition and calorie booster. It basically supports growth and development of low birth weight babies. HMF (Human Milk Fortifier) is cow's milk protein in a hydrolyzed (broken down) form so it is gentle on your preemie's stomach. In short, D. was introduced to cow's milk right from the beginning. This was not really by choice, it is already decided by the NICU team taking D.'s overall weight and development into account.

On the other hand, highest amount of milk I was able to produce per day was 350 ml in total. We were able to go with this amount until the 50th day. On the 49th day, D. started taking around 400 ml of milk per day as per the calculations of NICU team. I always knew in our second month we would have to supplement with formula if I could not produce more.

Formula has never been in my agenda. I was very frustrated that I was not able to produce the right amount.

And after seeing so much in NICU, babies with brain injuries, babies with NEC (Necrotizing enterocolitis, serious gastrointestinal problem that mostly affects premature babies), I was very hesitant to introduce formula. I was convinced that if we introduced formula, D. was not going to be able to digest it and ended up having stomach problems.

Week before formula introduction, I did an intensive research on formula types and brands. I had a chat with the doctor on how THEY picked formula for preemie babies. They used a formulation that is specifically designed to boost preemie babies' calorie intake (S-26 Post Discharge Formula). However, I was not comfortable with some of the ingredients in this formula. So I decided to proceed with HIPP Organics Stage 1. I was not 100% comfortable even with the one I picked but then I came to terms with it.

Main difference between the one I picked (HIPP Organics Stage 1) and the one they recommended (S-26 Post Discharge Formula) was the number of calories. HIPP Organics Stage 1 included is 66 calories/100 ml whereas S-26 Post Discharge Formula had 73 calories/100 ml. After my discussion with the NICU doctor, we decided to track her weight gain and and see if this difference in total intake had an impact her development.

Clean and organic ingredients have been the most important factor for my decision. I also wanted to give her something that is somewhat similar to the taste of breastmilk. I thought HIPP Organics did a good job with that. (Though there is another brand - Kendamil - which did a better job yet it was not marketed in the city I lived.)

The first night she was fed with formula, I couldn't sleep. In my mind, it was like she was going to drink a bottle and then she would develop an allergic reaction right away. Nurses knew about my worries about formula and they promised me that they would call me right away if something happens.

Well..Nothing happened:) She drank it and she liked it. More importantly her stomach did not hate it:) And that is how formula came into my life and never left..