We have a small-twin in the high care unit receiving donor breast milk
(DBM), while the mother builds up a supply for him.  However she had
previously opted to formula feed, and so the big-twin has had some formula.
  The doctors have decided to give the healthy baby DBM too, in the hopes
that the mother will eventually be feeding both babies, and that in the
meantime his gut flora will normalise (if that is possible with pasteurised
milk.....the big question!)

I've re-read Marsha Walker's informative "Just One Bottle....."
http://www.naba-breastfeeding.org/images/Just%20One%20Bottle.pdf
The article says that it can take 2 - 4 weeks for this to happen *with
exclusive breastfeeding*.  I'm wondering if there is any further research
on how this would work with exclusive donor milk feeding.  Pasteurised
human milk is different in many ways to fresh milk... though obviously
better than formula.

The really complicating issue, the reason why we want to heal the gut in
this particular case, is that the baby is HIV exposed.  (In South Africa,
HIV+ mothers chose to breastfeed exclusively OR formula feed exclusively.)
 So it is vital to get this one right.    Obviously donor milk will be
better for the healthy baby than formula while in the hospital, but perhaps
the doctors shouldn't pin their hopes on this baby getting back to
exclusive breastfeeding?

I think this situation will arise again and again, so for me it's a burning
question.

Jacquie Nutt IBCLC
Drops for Life milk bank
www.drops4life.wordpress.com
Wellington, South Africa

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