These instructions are for Children’s Hospital of Philadelphia (CHOP) patients that receive human milk that is prepared with formula (22 kcal/oz) to meet nutritional needs.

For use with:

• Alfamino^® Infant
• Calcilo XD^®
• Elecare^® Infant
• Enfamil^®: AR, Infant, NeuroPro™, (NeuroPro) Gentlease^® , NeuroPro Enfacare™, Prosobee^®
• Gerber^® Good Start^®: GentlePro, SoothePro, Soy
• Similac^®: (Pro)Advance, Alimentum^®, Neosure^®, PM 60/40, (Pro)Sensitive, Soy Isomil^®, (Pro) Total Comfort™
• Neocate Infant^®
• Nutramigen™
• Pregestimil^®
• PurAmino™

Your child receives human milk that is prepared with formula to meet his nutritional needs. Human milk calorie concentration varies and it is about 20 calories per ounce (kcal/oz.). A healthcare provider has prescribed your child 22 kcal/oz. of human milk. This is made by adding formula powder to human milk. Use the mixing chart and instructions in this handout instead of the one found on the formula can. Your child’s health depends on following these instructions.

Supplies

Mixing chart for using scoops

Notes: There are 30 milliliters (mL) in 1 fluid (fl.) oz. Make sure formula powder is level and unpacked. Do not use the scoop that comes in the can of formula, use a teaspoon (tsp) instead.

Instructions

1. Gather your supplies.
2. Wash your hands with soap and water.
3. Measure the amount of human milk into a clean, dry bottle or liquid measuring cup. Pour the desired amount into a bottle.
4. Open the can of powder formula and use the right teaspoon to measure. Teaspoons of formula powder should be unpacked and leveled. Do not use the scoop provided in the can of powdered formula.
5. Add the powder formula to the human milk and mix together. Gently shake formula in a closed bottle or stir with a whisk in a liquid measuring cup.

Feeding and storage of prepared fortified human milk

To prevent bacteria growth:

• Feed fortified human milk to your child or cover container and store in the refrigerator.
• Throw away fortified human milk that is in the bottle 1 hour after the start of the feeding.
• Throw away fortified human milk that has been out of the refrigerator for more than 4 hours when given through a feeding tube.
• Throw away unused fortified human milk 24 hours after making it.

Your child is receiving a high calorie human milk, it is important to watch for:

• Less than six wet diapers in 24 hours
• Dark colored urine
• Loose or watery bowel movements
• Vomiting
• Sleeping more than usual
• Poor feeding
• Fast breathing

If your child has these signs, call their healthcare provider.

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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