First: Do No Harm is/should be the rule that all health professionals live
by.  Infant formula was introduced to well infants who had their own
mothers who were able to produce milk for them without any deference to
this maxim.  How does Maureen Minchin describe it? ... the world's largest
uncontrolled experiment, and our infants, the most fragile group in our
society are still being experimented on.

I understand that the VLBW infant probably wouldn't survive without the
work of our many and gifted scientists and health care professionals.  But
before we continue to experiment on these infants shouldn't we first be
showing that they do indeed suffer from deficits which we can correct.  I
recall the original research performed by Lucas back in the 80s where the
infants who were chosen to receive donor breastmilk performed much better
on all tests than the ones receiving formula  AND the breastmilk they
received was "drip" milk ie the milk that dripped from the opposite breast
as the donor fed her own child - no lactoengineering here!  (I'm not
supporting the use of drip milk, just demonstrating that even the 'poorest'
quality of breastmilk was better than the best formula)

Do VLBW infants who progress to full, unsupplemented (other than vitamins,
iron) breastfeeding (ie had fortified milk) perform poorly in the short-
and long-term compared to the ones who have to come off the breast to
receive formula?  How do they all compare to the well full term infant who
only ever received breastmilk?  What does telling a mother that her infant
will have to receive additional infant formula for many months after
discharge from hospital do to her resolve to continue to provide
breastmilk?  Will she continue to breast and bottle, or will she come to
the conclusion that her breastmilk isn't good enough, all formula must be
better.  Is this outcome better for the infant than all breastfeeds at the
breast without supplemental feeds?  Have the mothers going home following
these breast/bottle regimes been followed to see what they do end up
doing?  ie. does this intervention, which has as yet unproven long term
benefits, result in harm to these infants??

Continuing in this vein ... when we do have evidence-based proof that an
action causes harm, if health professionals continue that practice my
personal opinion is that the hospital's lawyers should be consulted.  If
health care professionals won't change their practice because of personal
whims, despite proof to the contrary, then it's up to the lawyers to say we
can't defend this action - shape up or ship out!!  We could all list many,
many instances of this, but the most recent one discussed here on Lactnet
is giving water between breastfeeds to jaundiced infants.

Opinionated
Denise

*************************************************
Denise Fisher MMP, BN, IBCLC
BreastEd Online Lactation Studies Courses
http://www.health-e-learning.com

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

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

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(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html