Most babies are fine drinking regular breast milk or formula. The usual caloric content of normal breast milk or formula is 20 calories per ounce. If your baby is smaller than normal or gaining less weight than expected, your health care provider may recommend that you make a higher calorie breast milk or formula for your child.

Your provider will usually recommend that you make milk that is either 22 or 24 calories/ounce, depending on how many calories your baby needs. You can make both 22- and 24-calorie milk using formula or breast milk.

There are some formulas you can buy that are intended specifically for children who were born prematurely. They are called premature follow-up formulas and already contain some of the extra calories needed when prepared according to the package directions. They are intended specifically for children who were born prematurely and should not be used by babies that were full-term.

**To prepare a 22-calorie/ounce breast milk:**Add 1/2 teaspoon of regular formula powder to every 3 ounces (89 mL) of pumped breast milk.

**To prepare a 24-calorie/ounce breast milk:**Add 1 teaspoon of regular formula powder to every 3 ounces (89 mL) of pumped breast milk.

When preparing high-calorie breast milk for premature babies you do not need to use special premature formula. Regular formula works fine.

**To prepare a 22-calorie/ounce formula:**If you are using concentrated liquid formula, mix 5.5 ounces (163 mL) of formula with every 4.5 ounces (133 mL) of water.

If you are using powder formula, mix 3 scoops of powder with every 5.5 ounces (163 mL) of water.

**To prepare a 24-calorie/ounce formula:**If you are using concentrated liquid formula, mix 3 ounces (89 mL) of formula for every 2 ounces (59 mL) of water.

If you are using powder formula, mix 3 scoops of powder with every 5 ounces (148 mL) of water.

If your baby was born prematurely, your provider may recommend using a special premature follow-up formula rather than regular formula to make high-calorie milk. You can buy these special follow-up formulas at the store. Some of these formulas for premature babies are Neosure Advance Premature Infant Formula and Enfacare Lipil Formula.

**To prepare a 22-calorie/ounce formula:**Mix 2 scoops of premature follow-up formula with every 4 ounces (118 mL) of water.

**To prepare a 24-calorie/ounce formula:**Mix 2 scoops of premature follow-up formula with every 3 1/2 ounces (104 mL) of water.

If you have questions about preparing formula for your baby, call your health care provider.

Written by Robert Brayden, MD, Associate Professor of Pediatrics, University of Colorado.

Published originally by McKesson Health Solutions LLC.

Adapted by Premier Care Pediatrics, PA.

Adapted by Premier Care Pediatrics, PA.

This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.