Research suggests that continuous feeds are not the best way to feed even
tiny preterm infants.  See the work of Richard Schanler MD, Carol Berseth MD
and Paula Meier RN, PhD ( in Texas).  Bolus feeds are more physiologic and
"bolus" feeds given over 1 hr. seem to have the best combination of safety
and stimulation of gastric and other enteric hormones.  Breastmilk, of
course, gives the best results, BUT, since BM is not pasteurized, the fat
DOES layer out and stick to tubing.  We therefore use small bore (micro-bore)
tubing in the shortest length possible and place the syringe pump below the
level of the baby with the point up at 45-90 degrees to minimize fat loss.
Your Neo may be a bit behind in his BM for premies reading, but he/she is not
crazy!
Nancy Wight MD, FAAP, IBCLC
Neonatologist
San Diego, CA, USA

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