Hi Seema

<<wouldn't powder formula decrease the lysozyme activity of the breast 
milk??>>

The short answer is, "Yes, significantly."


The 2005 HMBANA storage guidelines "Best Practice for Expressing, Storing 
and Handling Human Milk in Hospitals, Homes and Child Care Settings" 
(available for purchase from the HMBANA website, under, for some reason, a 
slightly different name) says on pg 26:

"Quan et all found that when bovine milk based formula is mixed with human 
milk prior to feeding, there is a significant (41 - 74%) decrease in 
lysozyme activity.  Additionally, there is significant increase in growth of 
E. coli, resulting from the decrease in anti-infective properties in the 
milk." - references: Narayanan et al 1984 and Quan et al 1992

"Adding human milk fortifier causes a 19% decrease in lysozyme but no 
corresponding effect on the anti-infective properties or increased growth of 
E coli." - ref Quan et al 1992

This is without the recent realisation of the risks of E sakazakii 
contamination in powdered artificial milk.

I know that many hospitals do not use fortifier (the other name implies it's 
made from human milk, and in the future it might be, as we saw from 
yesterday's post, but currently it's NOT from human milk).  I do not know if 
their babies have worse health outcomes... and I suspect not, though of 
course the reason for lack of fortifier might be economic, which might 
impact on availability of other care around those premies.  (If I remember 
correctly, the original research on Kangaroo Mother Care showed an 
ironically better survival rate for babies KMC'd in a poor hospital vs rich 
babies in incubators).

I would love to see the actual research showing the long term health 
outcomes of adding fortifier to milk for premature babies.  Anyone?

Jacquie Nutt IBCLC
South Africa

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