Lyne wrote regarding feeding management of preterm babies in relation to
Lucas article in Pediatrics 2001, sept edition.
The neonatologist in question has misread the article.  Lucas only
recommends in his conclusion special post discharge formula for those
parents who ELECTIVELY switch their infants to partial or exclusive formula
feeding during the first year.  He is the same researcher who passionately
supports breastfeeding as the result of his research into IQs and the
breastfed baby in which he demonstrated BF babies have significantly higher
IQs.  Also he has done research to demonstrate BF babies have 6-10 times
less incidence of decrotising enterocolitis.  Your neonatologist has only
read into the article what she has wanted to read--and yes there is a myriad
of research out there to support fortifying breast milk in premature
babies--however the fortification is gradually reduced naturally as the
number of BFs increase.  There is some debate amongst some of the research
community as to whether these babies should still have some feeds with
expressed milk and fortifier purely to continue the linear growth in these
vulnerable pre-term infants--and they do put forward a valid argument. Often
it is a difficult juggling act to balance all the information out there.  In
the SCN I work in we do fortify EBM but as more and more BFs are intruduced
this naturally peters out as the baby goes home exclusively breastfeeding.
However, from what I have read (although this is not what we currently
practice), I personally believe for those babies whose mothers switch to
formula, a specially fortified post discharge formula would be beneficial.
But in my eyes the benefits of exclusive breastfeeding wins hands down as
the number one choice for a whole host of reasons that we all know about.


To access the article you can get a 10 day free subscription to mdconsult;

http://www.mdconsult.com

You will have access to 0ver 50 journals some of which have loads of info on
breastfeeding.  Look particularly at Pediatric Clinics of North America both
Feb 2001 and April 2001 as they are special breastfeeding editions .

Marian Rigney RN

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