Anne wrote
<I work in an Australia NICU ,we stop HMF/LBW s26 at 2kgs.When babies
considered term should be treated as term baby not as preemie which is what
alot of peds forget.This means that they breast feed fully as per normal
term baby,if unable to suck feed every feed at breast then be offered EBM
via what ever means Mum wants to use.>

Anne I also work in a SCN in Australia and I am aware of the growing body of
evidence that HMF or high calorie formula is beneficial even post discharge.
It must be remembered that a 2 kg term or near term baby is  still a very
low weight baby and below the 3rd percentile.  I question why fortification
is ceased at 2 kg if the baby still remains in hospital for other reasons
and is not having all feeds from the breast.   Fortification has been
demonstrated in the short to medium term to enhance bone mineralisation and
to increase linear growth, head circumference and brain growth. In many
cases we do not cease fortification until 2 days prior to discharge so these
small premies get the increased benefits for longer.    Although we
currently do not continue fortification post discharge (we encourage
exclusive breastfeeding), I am aware from reading the literature and the
research on the topic that there may be very good and valid reasons to give
some extra supplementation (in the form of HMF) for some feeds post
discharge and even for several months post discharge.  I am open to new
ideas and change in this area.  Many of these small babies also are
discharged at 35 to 36 weeks and cannot (by definition) be considered term.
Marian Rigney RN and (hopefully in waiting) 2002 IBCLC candidate



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