3 month old infant that was born full term, NSVD w/o complications presents with seizure like activity to your ED. Pt is afebrile with normal vitals however lethargic and not actively seizing. Off the blood gas you note a Na of 113. What must you consider and ask mom?


A: how is she mixing the formula?

Turns out mom is mixing the formula at a ration of  1 scoop of powder to 8 oz’s of water to save on formula as she recently lost her job.

Formula costs approx $1.25 per oz

Proper Formula Prep

Concentrate: equal amounts of concentrate and water

Powder: mix 1 level scoop of powder for every 2 oz of water


off course other etiologies must also be considered and ruled out.