Hello Today I attended a lecture given by Dr. Allan Lucas, the often cited researcher from Cambridge England who did the long term studies on preterm human milk and IQ (also on it's protection against NEC) I was excited to hear about this visit because in our local regional 175 bed pediatric hospital there is virtually no support for breastfeeding in the NICU or anywhere else in the hospital. Mothers are regularly told their own milk is too hard for their baby to digest, it's too tiring, etc. So I assumed (silly me!) this guy would share his data and breastmilk would get some respect. Well guess what? He shared his IQ data, but only the part that refers to better IQs in babies given pre-term formula verses full term formula! Apparently there is a 5-6 point difference in IQ between term and pre-term formulas (actually for boys it is 13 points, less for girls) He said that five points may not seem like much but from a public health standpoint it is quite a lot. I kept waiting for him to go on to relate the even better outcomes for babies fed human milk, but he never did! (Did I mention his visit was sponsored by R***?) After making the point that what we feed babies in the early weeks can make a critical difference in their long term outcomes, he went on to stress the importance of how the baby is fed after discharge- stating that this is a neglected area. He said many babies eat like crazy after leaving the hospital because they have been nutrient deprived. Therefore, he thinks... and this was the crux of his talk, that we need "discharge formulas". (By the way he mentioned that he has designed one.) Dr. Lucas made the following statements about breastfeeding: *We have no idea whether sending them home breastfeeding is beneficial or not. *There is really no difference in growth between breastfed and bottle fed babies- in fact the bottle fed babies may even grow better. *Since babies aren't meant to be born too soon, we really don't have a good way to feed them, so (get this): if it turns out that human milk meets their needs it is almost a coincidence. He seemed to gloss over the benefits of breastmilk by saying that it is somewhat protective for NEC, and IS better tolerated by the baby but "at the end of the day it does not meet the needs of babies." When asked about human milk fortifiers he agreed that they can be used but he alluded to the possibility that they (the fortifiers) may affect the immune properties of the milk. He stressed a number of ways that human milk is deficient "it's critically low in phosphorus and proteins" also iron and zinc. I am an IBCLC who has been a LLLL for eleven years- one of those who never took a preparation course, and did very well on the exam. I really did not feel capable of entering into a debate with this man, but I felt sick to be sitting there realizing that the message the mostly resident doctors and NICU nurses were getting is that breastmilk isn't all that great so we need to use pre-term formulas, and develop discharge formulas. I wish I had had the nerve to ask him about his breastmilk IQ outcomes, but by the time I realized this info was not to be forthcoming it was clear that this was to be a formula talk, and I was chicken. I do write killer letters, though, so do you think I can do anything now to counter this anti-breastmilk presentation? I am open to suggestions. Sue Jacoby, IBCLC & LLLL Fresno California