Kathy and all:
Lucas and many other researchers (eg Schanler) have concluded that human milk
alone (especially after the first 2-4 weeks when the milk of mom's who
deliver premies is different, and closer to the needs of their infant) does
not give optimal growth (based on the only standard we have- in utero growth
curves) for preterm infants less then approx 1500 gms. Preterm infants do
better than they theoretically should, based on nutrient content of human
milk, but not as well as infants fed preterm formula or fortified human milk.
 Much as I hate to adulterate human milk, the research strongly points to the
need for added protein, calcium and phosphorus for optimum growth and
prevention of nutritional problems such as rickets.  We need to remember that
before the "unnatural" technologies of NICU care, most of these infants did
not survive.  Those that did were usually SGA (small for gestational age),
not really premies.  I consider human milk necessary, but not sufficient, for
preterms < 1500 gms.
Nancy E. Wight MD
Neonatologist
San Diego, CA

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