_09697_scnvitaminInfants - SCANNED TO PHARMACY STAT...

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Unformatted text preview: SCANNED TO PHARMACY STAT MEDICATION NICU / SCN Vitamin/Mineral Supplementation for Infant's under 2kg: Date: ____________________ Time: ______________ Infant under 2kg, initiate the following supplementation based on feeding product used once: • Enteral feedings established for over 48 hours • Feeding formula or breast milk • Gastric residual under 3mL (if OG or NG feeding) BREAST MILK SUPPLEMENT When feeding > 100 cal/kg/day initiate: DISCONTINUE AT Add 1 packet Enfamil Human Milk Fortifier (HMF) to 50mL breast milk x 24 hours Use Enfamil Premature formula 24 cal/oz if no breast milk available. - thereafter Add 2 packets HMF to 50mL breast milk Discharge SUPPLEMENT DISCONTINUE AT Enfamil Premature formula 0.5mL (25 units) daily Aquasol E PO 2kg Similac Special Care formula - or Breast Milk with HMF 0.5mL (25 units) daily Aquasol E PO 0.5mL BID Multivitamin 2kg 2.5kg 0.5mL BID Multivitamin PO 2.5kg Soy 0.5mL (25 units) daily Aquasol E PO 2kg Lacto Free 25mcg BID Folic Acid PO Discharge Enfamil 1mL (360 mg)TID Calcium glubionate (Neocalglucon) PO Discharge Similac 1mL BID Neutraphos PO Pregestimil, Portagen* (10mg phosphorus per mL) PO PRODUCT USED Formulas listed below Discharge * Check with M.D. prior to initiation MD Signature _____________________________________________ Physician # __________________________ ZZ09697 (7/21/08) Patient Identification SAFH SDH SMCS SRMC NICU / SCN Vitamin/Mineral Protocol Orders for infants under 2kg ...
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