I would like to know if anyone has studied premature babies getting
expressed milk only and those getting expressed milk plus diluters.
This story of intolerance is so common, it seems to me, that it is
possible the babies gain more rapidly when given diluters, but are so
often put npo that in the end maybe they *don't* gain as quickly.

Polycose is frequently added to milk of older babies who are failing to
thrive.  I doubt that it has been approved for premature babies, but
maybe.  We are always willing to try anything, never mind the side
effects, just to get those premies to gain weight more rapidly.  All
based on the perhaps mistaken premise that the babies need to gain at
intrauterine rate.  Where on earth is the proof that they are better off
gaining at intrauterine rate than, say, as fast as we can get them to
gain on breastmilk alone?  Huh?  Yet almost the entire foundation of
using breastmilk diluters is this question of intrauterine growth rate.
(Also calcium, but the idea of the calcium is to increase bone density,
and a recent study from Scandinavia suggests that babies who get
expressed milk plus banked human milk had better bone density at 2 years
than babies who got expressed milk plus diluters or premature formula).

Jack Newman, MD, FRCPC (ranting again)