Hello  Today I attended a lecture given by Dr. Allan Lucas, the often cited
researcher from Cambridge England who did the long term studies on preterm
human milk and IQ (also on it's protection against NEC)  I was excited to
hear about this visit because in our local regional 175 bed pediatric
hospital there is virtually no support for breastfeeding in the NICU or
anywhere else in the hospital.  Mothers are regularly told their own milk is
too hard for their baby to digest, it's too tiring, etc.  So I assumed (silly
me!) this guy would share his data and breastmilk would get some respect.
 Well guess what?  He shared his IQ data, but only the part that refers to
better IQs in babies given pre-term formula verses full term formula!
Apparently there is a 5-6 point difference in IQ between term and pre-term
formulas (actually for boys it is 13 points, less for girls)  He said that
five points may not seem like much but from a public health standpoint it is
quite a lot.  I kept waiting for him to go on to relate the even better
outcomes for babies fed human milk, but he never did!  (Did I mention his
visit was sponsored by R***?)

After making the point that what we feed babies in the early weeks can make a
critical difference in their long term outcomes, he went on to stress the
importance of how the baby is fed after discharge- stating that this is a
neglected area.  He said many babies eat like crazy after leaving the
hospital because they have been nutrient deprived.  Therefore, he thinks...
and this was the crux of his talk, that we need "discharge formulas".  (By
the way he mentioned that he has designed one.)

Dr. Lucas made the following statements about breastfeeding:
*We have no idea whether sending them home breastfeeding is beneficial or
not.
*There is really no difference in growth between breastfed and bottle fed
babies- in fact the bottle fed babies may even grow better.
*Since babies aren't meant to be born too soon, we really don't have a good
way to feed them, so (get this): if it turns out that human milk meets their
needs it is almost a coincidence.

He seemed to gloss over the benefits of breastmilk by saying that it is
somewhat protective for NEC, and IS better tolerated by the baby but "at the
end of the day it does not meet the needs of babies."  When asked about human
milk fortifiers he agreed that they can be used but he alluded to the
possibility that they (the fortifiers) may affect the immune properties of
the milk.  He stressed a number of ways that human milk is deficient "it's
critically low in phosphorus and proteins" also iron and zinc.

I am an IBCLC who has been a LLLL for eleven years- one of those who never
took a preparation course, and did very well on the exam.  I really did not
feel capable of entering into a debate with this man, but I felt sick to be
sitting there realizing that the message the mostly resident doctors and NICU
nurses were getting is that breastmilk isn't all that great so we need to use
pre-term formulas, and develop discharge formulas.  I wish I had had the
nerve to ask him about his breastmilk IQ outcomes, but by the time I realized
this info was not to be forthcoming it was clear that this was to be a
formula talk, and I was chicken.  I do write killer letters, though, so do
you think I can do anything now to counter this anti-breastmilk presentation?
 I am open to suggestions.  Sue Jacoby, IBCLC & LLLL Fresno California