Nikki, I think two different issues are getting confused here - the question of what should be used for supplementation if it is used, and the question of whether to supplement in this group of mothers at all. I disagree with you on the first question, but let's for the moment set that aside and agree to differ. We still have the finding that, although current protocols would advise against supplementation in this particular subset of mothers (rapid weight loss but not at the 10% mark), this study found it to be markedly helpful as an addendum to breastfeeding support. I repeat - an intervention that we are normally told to avoid in a particular group has been found to greatly *increase* rates in that group. Why is that initial finding (and, yes, it is only an initial finding at this point) not worth further research?

I completely understand the reasons not to throw existing protocol out of the window based on a single small study. I understand the concerns about the study. I understand, even if I don't altogether agree with, the reasons for saying that supplementation should be done with donor milk rather than formula if it is done. But I can see no good reason not to at least *conduct further research* into the question of what effects controlled, limited supplementation has as an option for management of breastfeeding difficulties as an addendum to lactation support, and not to at least *consider and re-examine* the evidence base against supplementation at this stage to see how it stands up against this evidence.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome