Nancy
Thanks for writing. I wanted to point out again that I was not referring to
neos when I said "practitioners" but rather the peds and family docs I
currently work with. I'm not trying to bash them either as their focus is
not primarily neonatology. Unfortunately, I don't see evidence of their
using current best practice and I sincerely have come to the conclusion that
many just don't trust that breastmilk is a calorie rich and nourishing
substance. I totally agree with your statement "Assuming that all will be
well if we just use enough breastmilk alone is just as much an assumption as
all fortifiers are needed." I said the same thing in my last post, we
definitely need more research. We can't assume anything. But it is an area
that could show promise, particularly with later date premies. Please note
that in my comments I referred to 32+ wk'ers. I'm sure you and I can agree
that very sick and VLBW babies are a whole different scenario. Smallest baby
I ever cared for was about 380 gms, IUGR 28 WKS. She did survive without
much sequalae (retinopathy) last I saw her at a reunion. I have the utmost
respect for neonatologists, in general.
Best regards,
Laurie
Laurie Wheeler RN MN IBCLC
Mississippi USA

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