I have no first-hand NICU experience but I do have quite a collection of
the research. I'm certainly not condemning any needed supplementation in
the NICU, just sharing with you what has been written. I'm sorry there are
too many studies below to cite them all, but you can write me for
references.

I can't imagine that excess fat is what a preemie really needs (but that's
what they get, see below). There are studies demonstrating that the faster
the growth rate is for infants and children, the greater their chances of
adult cancer. In general, the bigger, the more matured, but I doubt that
size for gestaional age, versus feeding has been highly researched in terms
of final outcome.

Studies show that oral feeding of breastmilk is tolerated much soooner than
formula by mouth -- there must be a reason. Then of course there's the
necrotizing entercolotis caused by formula. Exclusive human milk for
preemies is shown to speed the digestive system maturation. There is a
study that shows that human-protein fortified infants gained more weight
and had better protein balance than bovine-protein fortified. There are
plenty of studies that demonstrate a higher rate of infection in preemies
fed formula or supplemented with formula (although not as much higher as
for term infants) -- what advantage could this be?? There are attempts to
increase bone mineralization through supplementation of preemies as well,
but studies show not only dangerous calcification in the kidneys, but that
the exclusive breastmilk preemies eventually show excellent bone
mineralization after a few months and that their mineralization is greater
in childhood in direct proportion to the amount of human milk received.
Studies show that growth rate of breastfed preemies is similar to that
inside the uterus (sounds good to me), and that eventually there is no size
difference in the children. The growth of head circumference, an indicator
of brain development, is not lower during premature hopitalization with
human milk only, and the human milk infants grow up with higher
intelligences scores and other neurological development parameters.
Permanent long-term immune development is superior in the breast milk
preemies as well. It is shown that early discharge of low-weight infants
leads to faster weight increases and longer breastfeeding with no decline
in health or survival.

The below, which speaks of term infants, I just wrote yesterday for
Mothering.com expert panel so please do not pass it on as it's as of yet
unpublished:
Formula-fed babies are shown to consume 20 percent more formula than usual
breastmilk consumptions, even though formula and breastmilk are similar in
calories.[1] It is assumed from studies that formula-fed infants need to
take in more in order to get the amounts of certain nutrients that their
bodies know they require.[2] The bovine protein in formula is more
difficult to absorb. Certain fatty acids in formula are unusable and simply
combine with calcium to be lost in the stool. The milk sugars are easily
absorbed, and the excess amounts are turned into body fat, making
the “average” formula-fed baby overweight, in comparison to natural,
intended infant weights. This higher weight is more rightfully considered a
result of malnutrition.

....there are no studies that demonstrate any advantage to baby fat (except
if faced with starvation in the future). There are studies that demonstrate
a greater likelihood of obesity[3] and a greater difficulty in maintaining
healthy blood pressure in adults [4] for those who were well “above
average” weight as babies. Among breastfed infants, even those with the
slowest growth rates show no differences in their average rates of
neurological development or of illness.[5]

1.  B. Lönnerdal, “Effects of milk and milk components on calcium,
magnesium, and trace element absorption during infancy,” Physiol Rev 77
(1997): 643–669.

2.  S.J. Fomon et al., “Infant formula with protein-energy ratio of 1.7
g/100 kcal is adequate but may not be safe,” J Pediatr Gastroenterol Nutr
28, no. 5 (May 1999): 495–501.

3.  M. Prokopec and F. Bellisle, “Adiposity in Czech children followed from
1 month of age to adulthood: analysis of individual BMI patterns,” Ann Hum
Biol (Czech Republic) 20, no. 6 (Nov–Dec 1993): 517–25.

4.  B.S. Simic, “Childhood obesity as a risk factor in adulthood and its
prevention,” Prev Med 12, no. 1 (Jan 1983): 47–51.

5.  K.G. Dewey et al., “Adequacy of energy intake among breast-fed infants
in the DARLING study: relationships to growth velocity, morbidity, and
activity levels. Davis Area Research on Lactation, Infant Nutrition and
Growth,” J Pediatr 119, no. 4 (Oct 1991): 538–47.

Linda F. Palmer, DC
Author: "Baby Matters, What Your Doctor
May Not Tell You About Caring for Your Baby"
www.babyreference.com
Infant Nutrition Consultations

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