----- Original Message ----- 
From: "laurie wheeler" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, December 14, 2007 4:32 AM
Subject: [LACTNET] neonatologists and breastfeeding

**Hello Laurie,

(snip)
> I think I also said in that post that this issue has been archived and 
> there
> are pros and cons to use of the fortifiers. I'm not saying what side is
> right, however I think I recall some posts on liberalizing volume for 
> "well"
> premies or "feeders and growers" as we call them, giving more than the 
> usual
> mls/kg with good outcomes.
(snip)

**As a volunteer, I mainly deal with healthy, term babies, so I do not have 
experience with premies, but I have a question. I'm still studying and a 
while ago, came across the statement (in Riordan) that premies ought to get 
more mls than are usually given, as breastmilk is so well digested, that 
they can manage to deal with bigger quantities. This fact would, to a 
certain extent, explain why premies grow more slowly on EBM than on formula: 
they just don't get enough. Therefore it was supposed to be advisable to 
simply encourage moms to pump more cc's, in order to administer more to the 
babies, without having to expose them to formula. Hind-hindmilk could do a 
lot of good work in this respect. Did I understand well? What is your and 
Nancy's opinion on this? Does hind-hindmilk, to a degree, compensate for 
fortifier? And what about human milk fortifier? I heard about it at the 
Donor Milk Symposium I attended had in Nijmegen on November 9th; Prolacta 
Science was there. I haven't been able yet to study in depth what the 
pp-handout said. I'm interested in your views, esp. bacause, like Cathy 
Watson said, it would be great to really reach exclusive breastfeeding, even 
for premies, but not when it compromises them.

Regards,

Marianne Vanderveen, Netherlands

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