Diluting Formula Question
 

Has anyone ever heard of diluting a babies formula because he isn't getting enough fluids? DCM informed me last night that her dr instructed her to dilute formula 1/2 and 1/2 because baby was dehydrated and has double ear infections. I found it odd but, was wondering if anyone else has ever heard of this.

**I also asked for written orders from the dr as I didn't think we could alter their formula like that**

I've never heard of this. Usually watered down juice or pedialyte would be recommended- I think?!

I've never heard of that.

If it's 'doctor's orders', then I would require a doctor's note to do so.

If it's just what mom wants, then I would tell her I can't do that. I have to feed the baby properly according to the directions on the formula container.

Also, if the baby were dehydrated, I might tell the mother that the baby needed to stay home until he/she is back to proper health.

For a baby being dehydrated, all I've ever heard of is they are given Pedialyte to re-hydrate them. I've never been told to do anything different with their formula.

I would ask for written orders from the doc, but I don't find this too strange for a short term concept. I wouldn't do it all the time, but while the baby is getting over whatever is happening, perhaps the formula full strength is too strong?

I told her yesterday I would need the Dr's orders. He isn't drinking much at all. He's been here 5 hours and has had 3 oz. Happy enough but, not drinking as much as he usually does.

I would send home. NO WAY would I want a dehydrated infant refusing fluids on my watch. I would also want him eating/drinking normally before he returns to care.

I've also never heard of this. Pedialyte, yes.

I texted dcm to let her know. She says she is going to call the dr. and also said to give him a regular bottle when he wakes up. I did let her know he is sleeping a lot more then normal.

It does have me concerned.

So did mom bring you the dr's orders stating to dilute the formula?

I have never heard of this. Of course that doesn't mean much :lol: just that I've never heard it before

I would absolutely NOT dilute formula. If a dr ordered that I would question his credentials.

Pedialyte is made to rehydrate.

Secondly, I exclude infants who are not drinking normally, who aren't peeing normally, or who are sleeping more than normal.

Also, I'd question fever hiding. Babies don't get dehydrated simply from ear infections.

Thank you for you input everyone! It seemed odd to me and I was wondering how he became dehydrated from ear infections as well. It didn't make sense to me at all. Dcm was very persistent that it was from ear infections and they were caused by first and second hand smoke. That is what she says the Dr said. I don't know who smokes around him. I do know he goes to bed with a bottle and is in a garage heated with a wood burning stove for hours on end. I know the first can lead to ear infections not sure about the second.

Could baby be dehydrated because of the pain from swallowing while having ear infections? I wonder
Doc didn't just order water in between feedings

Be careful....mom may be trying to save money by having you water down the formula. Demand a note from the doctor on official paper or RX pad.

My own experience...when my now 7 year old was a little baby, I had a bit of trouble at night where she seemed to want to suck on the bottle, but not necessarily eat, the formula would be wasted because she didn't drink it. I tried different pacifiers, but she liked the nipple on the bottle. So I tried letting her just suck on the nipple but I guess it wasn't the same since it felt different with no liquid behind the nipple.

I knew she wasn't eating and was just suckling, so I put water in the bottle and let her suckle at night. The bottle remained full, she just kind of sucked a little, maybe drank a small amount.

Anyway, I mentioned it at the dr one day, looking for suggestions, and got scolded. I was told she receives plenty of water in her formula, which should always be measured correctly and never diluted, which will make the baby still hungry and they will receive more water than their body needs and could actually be harmful if the baby is young.

I ended up letting her cry it out. I felt she was too young, only 2 months, but she wasn't hungry, hurt or in need of changing and I didn't want any night time habits, so the doc recommended cry it out, and it worked.

Anyway, that's just my experience, being told NEVER to give an infant more water than necessary. It might have been just my pediatrician's opinion.

Usually if an infant is dehydrated they will give pedialyte. Diluting the formula reduces the child's daily nutrition intake, making the situation worse

I have never heard of that. How old is the baby?
Debbie

No. Babies can't have extra water.

Originally Posted by nannyde:
No. Babies can't have extra water.

I don't know if I would just throw that out there without explanation, Nan. Most of my kids were breastfed, but one did have formula for a bit, and coming back from a vomiting/diarrhea episode, we did pedialyte for a day, then diluted formula, slowly making each bottle stronger as tolerated. (all doc approved)

I would say the large majority of the time, babies should not have extra water, but I don't think I would blanket statement that idea.

I have never heard of a doctor recommending to dilute the formula.

I was curious so I googled diluting formula. I found that there is a site that recommends diluting the formula by half for the first 24 hours only then it back to regular formula to aid with dehydration. Otherwise it is damaging to the kidneys if formula is diluted for too long.

http://babygooroo.com/2012/03/extra-...ul-for-babies/


an article on formula stretching and water.

DCM came today with a note written on a script pad saying baby can have formula. I explained to dcm I hoped he could have formula since that is all I give him. She told me that the nurse practitioner at the same day care told her to give dcb the diluted formula, not his regular dr. I told her that I wouldn't dilute his formula as this was not an acceptable note from the dr. Also, inquired if she was still diluting as a week has passed and surely he isn't still dehydrated. She is, she said she is adding 3oz of extra water per bottle. When asked why she said she thought he was dehydrated since his meds were giving him diarrhea. I haven't seen any diarrhea today.

Originally Posted by nannyde:
http://babygooroo.com/2012/03/extra-...ul-for-babies/


an article on formula stretching and water.

At our last food program in-service this was talked about. I have explained this to dcm but, it seems to fall on deaf ears.

Originally Posted by Jack Sprat:
At our last food program in-service this was talked about. I have explained this to dcm but, it seems to fall on deaf ears.

She's formula stretching. Tell her you will either have to have a Doc order regarding it or you will be forced to contact DHS. You could send her info on hyponatrenia and ask that she review and sign that she has been given it. It may be too risky to care for the baby if she doesn't stop it. How old is the infant and weight please.

He is 8m olds (last Friday) and weighs 18lbs.

Originally Posted by Jack Sprat:
Thank you for you input everyone! It seemed odd to me and I was wondering how he became dehydrated from ear infections as well. It didn't make sense to me at all. Dcm was very persistent that it was from ear infections and they were caused by first and second hand smoke. That is what she says the Dr said. I don't know who smokes around him. I do know he goes to bed with a bottle and is in a garage heated with a wood burning stove for hours on end. I know the first can lead to ear infections not sure about the second.

How is the baby? I hope mom took the baby in. Especially if the baby's dehydrated. That could become a medical emergency. Dilute NOTHING.... but, when I had ill kids not really wanting to feed, I fed a tad bit of pedialyte between feedings (even a few sips is better than nothing) if they seemed like they needed more fluids. They loved the taste of the Gerber form of pedialyte better than actual pedialyte, but IDK if Gerber makes it anymore. This was YEARS ago and I never saw it again.

Originally Posted by Unregistered:
How is the baby? I hope mom took the baby in. Especially if the baby's dehydrated. That could become a medical emergency. Dilute NOTHING.... but, when I had ill kids not really wanting to feed, I fed a tad bit of pedialyte between feedings (even a few sips is better than nothing) if they seemed like they needed more fluids. They loved the taste of the Gerber form of pedialyte better than actual pedialyte, but IDK if Gerber makes it anymore. This was YEARS ago and I never saw it again.

Water is not used to rehydrate infants. Pedialyte is.

This mom is formula stretching and saying words like Doctor and dehydration to the provider.

Originally Posted by Jack Sprat:
He is 8m olds (last Friday) and weighs 18lbs.

Nope. I personally would require a Doctors note. Three ounces of water with each bottle at home is a lot for an 8 month old. Ask her if she is having issues buying formula. If she is on WIC then she may be used to all of his formula being free and now she has to buy it. Usually around six months they don't receive enough to cover the month.

Originally Posted by Jack Sprat:
DCM came today with a note written on a script pad saying baby can have formula. I explained to dcm I hoped he could have formula since that is all I give him. She told me that the nurse practitioner at the same day care told her to give dcb the diluted formula, not his regular dr. I told her that I wouldn't dilute his formula as this was not an acceptable note from the dr. Also, inquired if she was still diluting as a week has passed and surely he isn't still dehydrated. She is, she said she is adding 3oz of extra water per bottle. When asked why she said she thought he was dehydrated since his meds were giving him diarrhea. I haven't seen any diarrhea today.

Mercy...no.
We did 24-36 hours as he was coming off vomiting/diarrhea. That I could see, but still, that should be mom's deal to handle. At this point, I have to go along with Nan; she is formula stretching. Highly dangerous.

I gave dcm the article on that NannyDe referenced. She read it and said she doesn't buy it and she is following what they told her to do. I explained that is was dangerous and I found it very odd they would tell her to do that. I did tell that I still won't dilute his formula. She was okay with that. Which makes me wonder if it is a cost issue. I provide his formula here. But, won't be for long unless she allows him to start solids here. I am only reimbursed for two snacks since he isn't eating anything but, formula here. I don't think she is on WIC or has ever been. I know she is aware of the program.

Originally Posted by Jack Sprat:
I gave dcm the article on that NannyDe referenced. She read it and said she doesn't buy it and she is following what they told her to do. I explained that is was dangerous and I found it very odd they would tell her to do that. I did tell that I still won't dilute his formula. She was okay with that. Which makes me wonder if it is a cost issue. I provide his formula here. But, won't be for long unless she allows him to start solids here. I am only reimbursed for two snacks since he isn't eating anything but, formula here. I don't think she is on WIC or has ever been. I know she is aware of the program.

If she is really worried about his health, she would insist that you both follow the same plan of action. Since she is completely fine with you giving him normal formula at daycare, this issue is clearly not about getting him healthy but about saving money by watering formula.....a very common occurrence unfortunately. Now that you know what she is doing, you know it is unsafe, and she cannot provide documentation from the doctor, you should report with the situation to child services. If she is comfortable doing stuff like this, who knows what she is doing in order to save money or skimp on child needs. You report and leave it up to them if it is something to intervene on.

I agree with the pp. If she doesn't care about it being consistent between home and daycare, I highly doubt it was ever a medical issue. I personally wouldn't want to care for the child anymore, knowing she is diluting at home. Too much liability! I would terminate to protect myself from her actions. I know it probably sounds extreme, but if she is doing that at home and he comes to dc and starts to have issues, that could be a big problem. If nothing else, I would make her sign a form stating what she is doing just to cover my booty.:)

I've never heard of diluting an infants formula to ensure more fluids. If this is what a parent is requesting the staff to do, I'd require a doctors note. The formula ratios are a certain way to ensure adequate nutrition.

I wouldn't want to care for this child anymore, knowing that mom is purposely denying the child if what he needs in order to save money. I would term and report- we all like to save money where we can, but Never at the expense of a child!

I sent dcm a message letting her know that I would need a signed note from her. Her response was that I didn't need to dilute at daycare she would at home. She isn't getting it. So now I'm calling state.