This is one of those that needs to be carefully read. Its an interesting
study, and I don't want to be someone who only looks for flaws in research I
"don't like", its not so cut and dried. 
They studied babies whose moms all provided milk, but randomized those whose
moms couldn't make enough to get either fortified donor milk or premie
formula as the supplement. 

They found that the rates of NEC and sepsis were no different between the
two supplemented groups, but were 2.5 times higher in both supplemented
groups compared to babies fed only mom's milk. 

Good things:  babies in both supplement groups got similar amounts of
maternal milk; randomization worked pretty well. 

Design issues that make it harder to generalize the results widely: 

they didn't start collecting data until babies had reached about 30% of
total enteral feeds, and did not say for certain if ALL feeds prior to this
time were maternal milk or not. Human milk for early feedings (including
donor) has been shown to be protective. 

21% of the kids in the donor group were changed to formula because of weight
gain issues, but, in line with appropriate "intention to treat" analysis,
were kept in the donor group for analysis. Based on some back of the
envelope calculations, if 70-100% of the excess bad events in the donor
group vs mother group were really in kids who got formula, that explains the
no difference shown. I suspect that there really was no difference, but I
wish the authors had described an analysis with those kids thrown out. I'm
sure they did it, these are top-knotch folks.

They are also very pro-breastmilk for preemies. The discussion clearly
emphasizes that kids who got all mom milk did better on all fronts than
those fed anything as a supplement. 

Anyway, that's my take on it.


Tarah Colaizy, MD, MPH
Staff Neonatologist, Assistant Professor of Pediatrics, University of Iowa
Breastfeeding researcher in training!
[log in to unmask]

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

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html