Dear Colleagues,


A question came to me from a friend working with a lactation support nurse in Cambodia and as I do the research I wanted your thoughts as well.  The baby is 34 weeks, on mixed feeds by ng tube.


When a mother is offering mixed feeds - expressed breastmilk (EBM) plus formula - is it preferable to do EBM first then the formula or to mix and feed?  I know the practice in the NICU in the hospital where I work is to do breastmilk first then "top off" with formula if needed.  This supports my personal thought - to give the EBM first to coat the gut and assure none is lost if the baby doesn't take the entire volume.  I need to find a reference for her to back that up and that has not been easy to do.


Many thanks,


Cindy Garrison BS IBCLC

practicing in Pittsburgh, PA

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