I have not been able to read Lactnet much lately, but did take a look at the Schanler study and read some of the follow-up posts. A few things stand out for me. As pointed out by Nancy Wight, there was some value to donor milk, compared to formula only. Even if it is not statistically significant, each of those insignificant statistics is a real live baby and the benefits to even one baby should not be overlooked. One must keep that in mind when evaluating results and then using them to formulate policy. There is not a real substitute for fresh(or frozen) mothers' own milk. While many elements are preserved, at least at some level, even after pasteurization, there are others that are destroyed or altered and they may be the ones that prove to be most important in establishing maximum immune function. We need to be pushing hard for programs which maximize the use of MM. Yes, they are time-intensive and cost money, but so does caring for a critically ill baby. Just a few extra days in a NICU represents an enormous cost which could possibly be avoided in a significant number of cases by increased use of MM. STS can also be a critical element for many of these moms and babies. There are many NICUs that want MM, but not mom - just drop off the milk, please, and go away so we can handle the details. It seems to me that often one goes hand-in-hand with the other - the closer the bond between mother and child, the more likely that milk will be forthcoming, not to mention other benefits. We need to be trying for the whole package whenever feasible. Affecting change in the NICU is a very difficult task to undertake. Perhaps it would be useful for those IBCLCs who work in this environment to seek each other out in a more deliberate fashion and form a working group that may be better able to influence policies and procedures. Perhaps lactation consulting has reached the stage where we need to be forming more specialized frameworks in order to be most effective. The older I get the more difficult it becomes to spread myself too thinly (just the opposite of what I thought would happen - what became of all that extra time I was going to have in my empty nest?). Many NICU IBCLCs are not on Lactnet. Many are probably not even members of ILCA. How do they start linking up? Nurses specialize and the specialties have their own organizations and even journals. Perhaps more people would join ILCA if it included a way to work more closely with those in a similar environment. Just a little free association here. Food for thought. That's all for now. Good luck to all of you who are working with these special babies. It is not an easy road to hoe. My hat is off to you all. Warmly, Sharon Knorr, BSMT, IBLCL Newark, New York (upstate, near Rochester) -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.14/79 - Release Date: 8/22/2005 -- No virus found in this outgoing message. Checked by AVG Anti-Virus. Version: 7.0.338 / Virus Database: 267.10.14/79 - Release Date: 8/22/2005 *********************************************** 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(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html