Whew!  Caught up once again with Lactnet.  I noticed some discussion of D5
vs. formula in the first few days when colostrum was not available in
sufficient quantity.  Our practice has been to use D5 for the first day or
so, but typically start formula by 2 days because mom and baby are going
home and we need a plan until the milk starts showing up.  Our policy is to
use Nutramigen (protein hydrolysate formula) in the hope that there would
be less chance of sensitization assuming mom went on to fully breastfeed.
We usually use Nutramigen for two weeks.  If it appears that baby is going
to require long-term formula supplementation, a regular formula is then
recommended.  We started doing this after ILCA in 94 when I heard Dr. Sami
Bahna speak on breastfeeding and allergies and asked him if this might be a
helpful practice.

So, what about the possible link with early milk feeds and diabetes?  Might
the Nutramigen decrease the odds of that, or should we be recommending D5
and drops of colostrum longer?  It seems that for a lot of moms with
non-latching babies who are pumping, it's often day 4 before we see much in
terms of milk supply.  Any thoughts from you wise ones?  Dr. Jack?

Becky Krumwiede, RN, IBCLC, Appleton, Wisconsin
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