At 09:39 AM 09/04/2004 -0400, you wrote:
>I just read in Lawrence that if a mother must supplement with formula she
>should use low iron!  The excessive iron in formula binds with the
>lactoferrin in breast milk and interfere with its protective
>activity.Unfortunately she doesn't give a specific ref.

That was my understanding.  I have seen and have been unable to locate in
my files an old reference (probably from early 80s) which warned against
combining formula and breast milk in the same feeding container. If my
memory correct the caution was due partly to the actions of lactoferrin.
Both that it would increase the bioavailability of the iron present in the
formula and that too much iron would interfere with its protective activity.

This question is actually quite important in my area. While we would love
for all infants to receive full breastmilk feeds we do not have the current
ability to provide full breastmilk supplements to all infants. In
situations where the mother is able to develop a milk supply but not enough
to meet her infant's needs we strongly encourage women to continue to offer
the breast. Most do so and will supplement as needed until the intake of
solids reaches the point that they can eliminate the bottles or until their
breastmilk supply diminishes entirely. This is not an either breastfeed or
formula feed situation. Every feeding of breastmilk has value and we treat
it as such, celebrating every drop the moms produce. However we are in some
disagreement over whether the supplement should be iron fortified or non
iron fortified formula (which does contain some iron just not as much).
It was my understanding that the best combination was non iron fortified
formula while receiving breastmilk feeding switching to enriched  iron
formula if infant weaned.  Some staff have insisted that combining formula
and breastmilk feeding changes the gut (they thought through inflammation)
and that the infants would require higher than normal levels of iron to
compensate.
Thank you for your participation in the discussion!

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