If you’ve recently been told by your healthcare provider that your child needs their calories increased or their infant formula concentrated, there may be several thoughts running through your head – “What does that mean?” “How long do I have to do this for?” “Does it mean something is wrong with my child?” These are normal thoughts, however concentrating infant formula does not have to be overwhelming. Let’s break it down:
What is concentrated infant formula?
Concentrated infant formula is achieved by adding additional infant formula powder on top of the standard recipe that is found on the infant formula can in order to increase the calories per ounce of infant formula. Adding too much can cause intolerance, so only do this when instructed by a doctor or dietitian and follow their exact recipe.
Why is infant formula concentrated?
Infant formula is concentrated to increase the amount of energy and nutrients your baby gets from each fluid ounce. Often, infant formula is concentrated when an infant has a medical condition that requires a fluid restriction or causes increased energy needs. If your infant has difficulty feeding, they may need a concentrated formula in order to meet their nutrition needs with less volume.
How long is concentrated formula needed?
Your healthcare provider may ask you to concentrate the infant formula for a short period of time if your child’s weight gain has recently slowed down. If your child has a chronic medical condition that increases their nutrition needs or reduces the amount of formula they can consume, they may require concentrated infant formula for a longer time. Your physician or dietitian will develop a recipe unique to your child’s needs. Make sure you are comfortable with their instructions on how to properly mix the infant formula. Your provider will closely monitor your infant’s growth and tolerance to the infant formula.
Challenges and concerns with concentrated infant formula
While concentrating infant formula can be a helpful tool to support an infant’s growth, there are some risks that need to be taken into consideration:
- Mixing errors: it is very important to ensure that infant formula is appropriately measured. If too much powder is added, it can lead to vomiting or constipation. If too little powder is added, poor growth or electrolyte imbalance may occur.
- Additional caregivers: since concentrated infant formula is not prepared using the instructions on the formula can, it is important that any additional caregivers can demonstrate proper mixing of infant formula. Make sure that dry measuring tools are used for powder and that liquid measuring cups are used for water.
- Safe water preparation: your healthcare provider may ask you to boil water when preparing powdered infant formula in order to reduce the risk of contamination. They may also want you to use water at a specific temperature. Follow any instructions received and check with your physician or dietitian prior to making any changes.
If your baby has high energy requirements and needs more calories than they are currently getting, the doctor or dietitian may recommend Nutricia Fortini™ Infant – an infant formula designed to reduce the risks associated with concentrating infant formula. It’s also a ready-to-feed liquid designed to be easy for parents and caregivers, with no mixing required. Fortini™ Infant is a high-energy and high-protein, infant formula designed for infants with poor growth, fluid restriction and/or increased energy needs. Ask your healthcare provider if Fortini™ Infant would be a better option for your baby than concentrating standard formula powder.
Work with your baby’s care team
Because infants are on concentrated infant formula due to a medical condition or poor growth, it is important to maintain close follow-up with your healthcare provider. They will monitor and ensure that your child is growing properly. Lastly, it is incredibly important to not make any changes to your child’s infant formula without first speaking with your healthcare provider.
Liz Bacon, MS RD
Liz Bacon is a Registered Dietitian most recently practicing at the Neonatal ICU at Texas Children’s Hospital in Houston. Prior to her time at TCH, Liz worked in the NICU at Baylor Scott & White Hillcrest Medical Center where she developed the NICU nutrition program and protocols from scratch as the first NICU RD at the institution. Liz looks forward to using her clinical experiences to help improve the lives of infants through nutrition as a Medical Science Liaison for Nutricia. She completed her undergraduate degree in Nutrition Sciences at Baylor University in Waco, TX and her Master’s degree in Nutrition, as well as a dietetic internship, at Texas Woman’s University in Houston, TX. Liz lives with her husband, Matt, and their two dogs, Chaco and Earl, and enjoys riding her Peloton, traveling, backpacking, and cooking.
Krugman SD, et al. Failure to thrive. Am Fam Physician. 2003;68:879-84.
Renfrew, et al. Arch Dis Child. 2003;88:855-8.
Plaster, et al. J Am Diet Assoc. 1996;96:A-64.
Altazan, et al. Pediatr Obes. 2019;14:e12564.
Rocha Carvalho, et al. JPEN J Parenter Enteral Nutr. 2000;24:296-303.
Fagerman. Nutr Clin Pract. 1992;7:31-6.
Labiner-Wolfe, et al. Pediatrics. 2008;122 Suppl 2:S85-90.