Discussions around formula vs breast milk

The roller coaster ride was extremely bumpy this week, Zane has done very well on CPAP and he went down on his pressure to 5 from 6.  The attending and I agreed to mix 75:25 of mother breast milk with similac special care 24 calorie formula.  This gives Zane 24 calories and added nutrients for growth.  Sam's milk tested at 24 calories. The next 'discussion" will be when to increase to a 50/50 mix.  The attending is pushing to add more to Sam's milk and after the discussion with the NNP on Wednesday Samantha stopped pumping, so much for family centered care.  As she puts it, 'if my milk is so deficient and needs all these additives why do you keep pushing for me to pump." Especially since a few weeks ago one of the attending spewed information about how good breast milk is and if Sam's supply diminished we could always use donated breast milk.  Which Samantha refused to do, by the time they pasteurize the milk the benefit is negligible, and formulas have been designed to meet the needs of the preemie so why not stick with something that the nutritional content is known. Unfortunately their is no consistency with information that is being provided and fellows/attending/NNP change information based upon what the agenda is for that day.

 For me I would like to see Zane tolerate this mixture for 2-3 days before going to a 50-50 mix.  The problem with going to a 50-50 mix in a short time is the infant can show feeding intolerance and the last thing we want to do is make him NPO (nothing by mouth) as this will let him get even further behind the growth curve. They also added benoprotein to his feeds to increase his protein intake. It would be helpful if they had him off his diuretics as this leechs out his minerals.  They (hospital) seem to be very worried about increasing his protein intake because of lack of growth over the last 8 weeks but they need to remember they (hospital) were in control of his growth and if he lacks it is because they did not monitor and achieve optimal nutritional status with his TPN and Lipids. It is unreasonable to think that 6 days of full feeds is going to replace 7 weeks of poor growth.

I was counting up the labs Zane has had by  heel stick, and as of Tues he has  105 heel sticks and 8 arterial sticks. No wonder the baby does not like when you touch his feet
We were also informed that he has pseudomonas in his eyes.  No one really know how this has happen some suggestions were from the cpap as it provides a moist environment, yet no one else seems to have had this problem.  Zane also had an eye exam done on Tuesday and the doctor did not not mention that his eye was infected, so I have to wonder what are they looking at when they do the exam?