Dawn, I am sorry I think I phrased my sentence incorrectly! I think the
babies that really seem to need the fortification are the very tiny ones,
the reason is the phosphorous and calcium as a few have already
mentioned. "Generally" under 2kgs this is not often used! Varies from
hospital to hospital and country to country, depending on the Dr. who is
ordering, and hospital practices! However as I have been informed by the
Dr. in charge of our NICU there are studies that recommend fortification
for the first 6mths of life for premies. The so called lacto-engineering
that Paula Meier advocates, as far as I am informed, only involves the
skimming for the fat and extra calories. These babies still receive added
phosphorous and calcium, as do babies that have artificial milk depending
on the content in that milk of these minerals, varies again! This is only
information but not necessarily my own opinion! I think it would be great
to have some studies on with and without, but this is of course easier said
that done. Where is the neonatologist that would not fortify milk by an
extremely tiny preemie, and give it to others in the same unit? More than
25yrs ago I too looked after babies with weights under 600gms and no
fortification, but do we know today if they had bone growth problems or
not? I think it is very difficult to decide what is right and what is not.

This discussion is great and I think thats why Lactnet is so good to be
able to talk about things like this and exchange our experiences. Keep it
up you wise people.

Kerri Frischknecht RN.RM.IBCLC

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