I still maintain the AAP does not have recommendations re discharge nutrition
for breastfeeding/breastmilk-fed ex-premies.  I have been through most of the
800+ pages in the "yellow book" (AAP Pediatric Nutrition Handbook, 4th
edition, 1998) and the only reference I can find is:

page 72:  "With infants now leaving neonatal units at weights as low as 1500
g, reevaluation of the discharge formula prescription is needed.  The
continuation of preterm formulas for a period after discharge provides one solution to
this problem; however the cost and availability of these products may be
limiting factors for some families.  Preterm discharge formulas are becoming
available at a cost slightly greater than that of term infant formulas.  These
products provide preterm infants a nutrient intake that is between a preterm and
term infant formula.  The use of preterm discharge formulas to a postnatal age
of 9 months results in greater linear growth, weight gain and BMC compared to
the use of term infant formula."

There is NO mention of what to do with the breastfeeding infant.  The "yellow
book" is currently being revised - there may be some recommendations in the
2004 edition.

Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital & Sharp Mary Birch Hospital For Women
Medical Director, Sharp HealthCare Lactation Services
San Diego, California, USA
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