Two different men whose friendship and insights I value.  

Jay, you know I love you, and you very right about looking more at short term 
gains than long term outcome.  Long term outcome is harder to prove and much 
more costly to do, but we must take a look at it.  We do know that short term 
protein deficit decreases intellectual function.  We also know that too rapid 
catch-up growth gives us short, fat, unhealthy children with high blood 
pressure as adults.   I am also constantly being harassed by insurance companies to 
get babies out of the hospital sooner. 

I also know that Rich Schanler values human milk - at this point mothers' own 
milk.  If further research shows the value of donor milk, he will value that 
also.  I am not defending his study, just explaining it.  I will post my 
letter to the editor of Pediatrics here when I have finished it.  I am also 
requesting other physicians knowledgeable about donor milk write letters as well.  I 
will be explaining the study in question (and its problems) to many different 
audiences over the next few months as I lecture.  I have also sent my comments 
to all my partners (22 of them) and the California Perinatal Quality Care 
Collaborative.  I am doing every bit of "damage control" I can.

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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