If your baby was born prematurely or underweight or if he's falling off the normal weight charts, your doctor might suggest giving him special high-calorie formula. Sometimes called premature infant formulas or transitional formulas, these types of infant nutrition supply more calories per ounce and also provide larger amounts of nutrients such as protein, additional vitamins and minerals.
Most infant formulas contain around 20 calories per ounce, approximately the same amount as breast milk, although the composition and calories in breast milk varies over the course of a day. High-calorie formulas typically contain either 22 or 24 calories per ounce, although some formulas provide even more calories, up to 30 per ounce or more, according to preemietoolkit.org, a website of the National Initiative for Children’s Healthcare Quality in Australia. Very high-calorie formulas might be used if your baby can't consume large amounts of formula and needs a more concentrated formula. Premature babies need more calories per ounce to grow than full-term babies; giving them both the calories and the extra nutrients they need helps brain growth as well as physical development.
You can create high-calorie formula either by buying it ready-made or ready to reconstitute according to directions on the package. You can also add more powder to regular commercial formula to create a higher-calorie formula. The amount of powder will vary, depending on how many calories per ounce your doctor wants your baby to have.
Breastfeeding and High-calorie Formula
In some instances, your doctor might suggest high-calorie formula even if you're breastfeeding or giving breast milk through a bottle. Formula contains more protein than breast milk; premature babies might need higher amounts of both protein and certain vitamins and minerals such as iron in their diet. If your baby isn't able to nipple-feed yet, it's easy to mix formula with expressed breast milk and give it through a tube feeding. Once your baby can breastfeed, your doctor might still suggest giving him a bottle of breast milk supplemented with formula every day, according to MedlinePlus.
Never make a decision to increase the calories in formula on your own. Your doctor should make the call on whether high-calorie formula would be beneficial for your baby and will also tell you exactly how to mix it. Adding additional powder to formula also adds additional vitamins and minerals that are not only unnecessary but could possibly be harmful. Give high-calorie formula only as long as your doctor recommends. Many premature babies will stay on high-calorie formula until they reach 6 to 9 months corrected age, according to registered dietitian Alisa DeWeese.