Elisheva raises excellent questions in her post about donor milk as "treatment" vs. nutrition, and whether this is a "real world vs. ideal world" issue when it comes right down to the nitty-gritty. My thinking is that it's both; that the issue is one of priorities and (like everything else, it seems) a matter of supply & demand. OR, more exactly, demand and supply. So we *know*, beyond a doubt, that all babies should get human milk - if not their own mama's, then WHO #3 or #4 (from a single donor, or pooled). But not everybody knows that, or ranks it of sufficient importance, so that sufficient demand is not created to make the supply available. I'm pretty sure that if the universal need for human milk were taken absolutely seriously, there wouldn't be a shortage of supply - we know that the stuff is created bountifully, and it's not all that big a deal to share it. But it's a lot like regular old direct nursing - the demand must be there to bring in the supply. So, until a child's need for human milk is taken as seriously as its need to breathe or sleep, and until artificial foods are seen as an absolute last resort, it will continue to be the *donor milk* that is viewed as the extreme measure. As long as the perception is that artificial milk is an acceptable and OK substitute, there will not be the consumer (INCLUDING physician/medical personnel) demand that will bring a sufficient supply of donor milk for any baby not getting its mother's own into being. And it's a catch-22, because as long as that's the perception (as it is now, for the most part), that will remain in some ways the truth - it's simpler and cheaper to pick up artificial milk and load it into the bottle than it is to obtain donor breastmilk. Imagine if the reverse were true: if donor human milk were as simple and inexpensive as formula is now, and formula were scorned and required medical intervention and a lot of rigamarole & money to obtain! So, until that happy day when WE Rule the Earth, or at least until enlightenment on this matter becomes more widespread, it's down to priorities; the sick babies with well-informed doctors, and the ones whose parents are educated and determined and assertive enough AND WEALTHY ENOUGH to afford donor milk will be the ones who get it. Everyone else is stuck with the de fault choices (of which commercially available formula is probably the best). As my dear little son said when he was not yet 2 years old and watched a bird pulling up a worm to eat, "Sad but true, life is tough." (But, to bring an encouraging tone to this otherwise gloomy observation, now that he's a grownup he finds life neither sad nor tough! Growth brings light!) Cathy Bargar RN IBCLC IThaca NY *********************************************** 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