Working in a NICU, I've faced the same problem as Brenda. Because of the nature of that environment we deal daily with babes that a bit ago would have had no chance of survival. Everything we do there is evolving as we all learn more. Especially in meeting all the nutritional needs and benefits. I'd love the research/ references also. But from another angle, I also ask my Drs. " so what does it hurt to give EBM the best chance to give all its benefits and just give it first- let it "coat" the gut and then give the formula?" The only benefit from mixing is its faster .....so? Even as the climate changes within the hospital setting, it's sad how we still have to prove or disprove various things involved with breast milk and breastfeeding. Just because we've always done it like that or the other hospital did that , etc. SO WHAT? Not everything we do in health care is absolutely evidence based.. many meds and techniques are used out of basic " guidelines".. all in the hope of improving the health and quality of life for that patient. We use noise, light reductions, skin to skin, positioning rolls, etc. to try and improve the outcomes by giving the most benefit to natural support... why not breastmilk? The good news is the climate IS changing. Breastmilk is being given and used more than it ever has before. We just need to keep trudging through the trenches and not just proving the research from "our" side but also asking WHY it has to be proved. When asked to provide long term proof I remind the Drs.... overall breast milk apparently did make a statistical difference to us as a species since we have lasted long enough to evolve to the ability to ask questions. Lisa Jones RN IBCLC Tacoma, WA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome