Greetings!
    I work as a staff nurse in a large Level III NICU and am also IBCLC certified.  As is common practice,when a premature infant reaches "full feedings"  we begin to fortify breastmilk with human milk fortifier to provide extra calories, vitamins, minerals.  When the baby is ready for discharge the fortifier is stopped.  Based on information gleaned from a recent conference,our neonatologists are now sending these babies home on a regimen of fortifying breastmilk twice a day with 1 tsp. of powdered 22 calorie artificial baby milk per 40cc of breastmilk.  This increases calories to 27 per oz and gives the extra nutrients such as calcium and phosphorus.  So, if the infant is at the breast exclusively (rare I know, but possible!), mom has to give a bottle 2x per day with this "fortified breastmilk".  I was told that there is no documented research on this when I asked how long it was to continue, but that based on the slower growth patterns and nutritional deficiencies of these babies this could be a good thing for the whole first year.  So, you can see the message that is sent to mom.  Of course that message is already in health care and became much more evident to me yesterday.  I am caring for an ex- 26 week gestation (corrected to 32 weeks) baby who is receiving 29 cc of breastmilk with human milk fortifier every three hrs. He is gaining weight well and making a lot of progress.  It was suggested that we  alternate fortified breastmilk feedings with feedings of 22 calorie artificial baby milk to really maximize our potential!!  When I question these things I am told that babies assimilate the nutrients better when given this way.  
    I am so frustrated...I could write pages.  I feel as if we are going backward each minute.  Are any other units doing this?  Is anyone fortifying breastmilk with anything other that the commercial cows milk based fortifiers?  I need some information to challenge this.
    Oh by the way, the conference speaker does his research with grant money provided by a major provider of artificial baby milk products.  SURPRISE!!!
    Sincerely, Donna (NJ, USA)
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