Welcome back to Lactnet, Lisa, and congratulations on your new arrival. I am not a specialist on premies. But I spent some time with one of the other IBCLCs in Norway last week who is a specialist on NICU babies and asked what the guidelines are in Norway for use of human milk fortifiers. (If any of you have seen 'Breast is best', she is in it, in the scene with the 30-weeker going to the breast.) Here, babies with birthweights under 1200 g are given fortifiers, both protein and fat. Babies whose mothers don't have enough milk are given banked human milk, with the smallest and least mature babies being given priority if it is scarce. Birthweight is the only criterion, not gestational age. The fortifier is not stopped before the babies are gaining, though I don't know that there is an absolute limit for when they stop. There is much discussion at the moment among neonatologists about increasing the weight limit where they recommend fortification of breastmilk, and increasing the length of time they are given it, because our babies don't grow as fast as babies where fortification is more widespread. I didn't get a chance to ask whether there are other lags in these babies compared to premature babies in other countries, nor whether anyone has considered the idea that the most rapid growth may not always be the best thing for a person. From your post it sounds like your baby is doing very well so far and is being treated the way we would treat such a baby, with early PO feeds of mother's milk, then breast and gavage. I don't have at my fingertips what our guidelines are for some of the other minerals. In the hospital where I work, all babies under 2500 g are to be given a commercial multivitamin supplement including folic acid from day 3, and iron supplementation begins for these same babies at 6 weeks, I think. I have mentioned before that the cod liver oil lobby is quite powerful here, and the official recommendation is that every person, of every age, take one teaspoonful of purified cod liver oil daily from the age of 6 weeks, for the rest of their lives. The main brand has some vitamin E added as an antioxidant, and supplies vits. A and D in standardized amounts. These vitamins are not present in large amounts in the other supplements. Rachel Myr Kristiansand, Norway *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html