Jennifer you wrote, "Valerie, you say that you do not see why we assume the
mother's gut is damaged, yet if you beleive that mixed feeds (or exclusive AF)
damage the gut permanently, then wouldn't most of us (mothers included) have
gut damage?

Yes, I don't know too many adults in the USA who were exclusively breastfed
from the moment of birth.  Thus I suspect that most, if not all adults sustain
gut damage. The statement I made is a poor one.  It reflects my concern that
in the case of a premie with gut damage the first issue addressed to the mother
should not be her diet.  Mothers of premies transitioning from the hospital
setting to a home setting are very vulnerable to what we say and how we say it.
 I believe the first concern should be to make sure that the mother has a
good milk supply for this infant.  Once an LC has evidence that the supply has
not been jeopardized by the hospitalization of the baby, pumping, stress, etc.
Then diet issues can be addressed.  It seemed to me that this  mother believes
that her milk was causing the constipation and therefore infant formula is
the answer.  And from the various posts on Lactnet, it seems to be that many
people believe that the cause is her milk.  Was supply issues examined closely?
How quickly does the gut heal in premature infants?  How long should a mother
reasonably wait in regard to this situation before resorting to some kind of
infant formula?  If we from the get-go assume that diet is responsible for the
situation, then we may have missed the real problem and a chance to address
that problem.

I would handle  cases regarding  exclusively, healthy breastfed infants born
at home differently.  A mother in this situation has not had her faith in
normal birth and breastfeeding severely challenged.  She has a relatively healthy
child in comparison to a premie with gut damage.  Her stress levels are
different and the whole aspect of this kind of case is different from a premie. I
would assume that diet, antibiotics or both may have entered into the problem
and that a resolution of the problem might be achieved by dietary means.  Even
in these kind of cases, I would still believe that breastfeeding had given
these babies a measure of protection against allergies and asthma.  How would the
health of these infants been if they had not been breastfed?  Would they have
survived?

How we present this issue to moms is critical.  Where does this problem
reside?  Is human milk non-protective in regard to allergies/asthma and the answer
specialized formulas?   I can see the infant formula industry clapping their
hands over this thought.  Yes, we will use the infant formulas that have the
imitation human milk components that protect against allergies/asthma.  And then
I can only laugh bitterly in regard to this situation.  Dietary issues are an
important aspect but how we present this to mothers will determine whether
she sticks to breastfeeding or assumes that her milk is bad and weans.
Valerie W. McClain, breastfeeding advocate

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