Good morning; regarding the question posed by Virginia, yes there are
reasons why a term baby can't breastfeed in the NICU, it could be that the
baby is on a ventilator, has had major surgery, or has severe respiratory
problems, to name a few. In these circumstances BF is not possible for a
certain time, but of course individually decided on for each baby. Virgina,
if this baby you are talking about is strong enough to drink from a bottle,
it is certainly strong enough to try breastfeeding. This mother has every
right to breastfeed, it is her baby, and if she is "strong" enough to say
what she wants, there does not seem to be a reason, medical or otherwise
that should stop her. Can you support her here? If this baby was or is not
gaining well it should not have restricted feeds, ok max. pause 3 hours if
the doctors wish, but if the baby wants something earlier ok too. Does this
baby have hunger signs before the 3 hours? I would bet it does if the
anaemia and all else is now ok. How long or often is the mother with the
baby in a 24 hour period, does she have the possibility of a room in or
near the hospital? Is this baby still so ill that it needs to be in the
NICU?

Regarding the fortification of Premie milk: I can only support Barbara
Wilson-Clay, Maureen Allen and others here that have explained what we are
doing is necessary at this point in time of a premie. The fortification is
based on, as Maureen said studies that show calcium and phosphorous are
needed for bone growth. The fat content is another story, but if a mother
can give her own milk, and the part of it that can help growth, rather than
an artificial additive, this is surely far surperior! It is also true that
under 2kgs (4lbs) milk is usually not fortified. One last thing I think the
premies that we are talking about are mainly the extreme ones, around 24
weekers and with very low birth weights 500g or so. These babies would
generally grow very fast if they were still in utero, faster than ever in
any life phase! They do need our help not only with the technics of today,
but also better knowledge of nutrition.

Kerri Frischknecht RN.RM.IBCLC in an NICU and Childrens Hospital.

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