Thank you, Nancy. I have been waiting to hear from the so-called "other
side." I was thinking that each case would be different and that I would
have to make a judgment based on the needs of each patient. My impression
from the literature is that protein supplementation is one of the things
that has made it possible for us to have good outcomes with the
teeny-tinies, whereas many years ago we simply couldn't give them the
nutrition that would allow their little nervous systems to grow and overcome
the disadvantage of being ex-utero too soon. Since I am not  a
neonatologist, I would certainly consult with my specialist colleagues for
nutrition guidelines while facilitating the breastfeeding relationships of
my  patients. Thanks again for clarifying the issue for American
practitioners.

Bonny Cannell Nothern, RN, MSN, RNC, WHNP, IBCLC
(please excuse me for including such an array of initials but I am figuring
it might serve to  reintroduce me to Lactnet after a long absence.)
Boston, MA

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