In a message dated 2/4/2003 1:02:49 PM Eastern Standard Time, [log in to unmask] writes:

> Over the past year, I have seen numerous posts about lactoengineering human
> milk to make it more suitable for an infant with some specific health
> problem.  Lactoengineering must then be based on the 
> premise that human milk
> is not good enough for certain babies and must be redesigned

Unfortunately, Valerie, when you remove most of a baby's intestines often there is no milk that is good enough for a baby to grow and thrive. This baby has lost most of the absorptive surface of the gut. It's not that human milk is not good enough, it's the baby's small intestine is no longer there. Often these babies are kept alive with total parenteral nutrition (IV nutrition) because there is no food that they can absorb--it passes right through them.  Lactoengineering can be life saving for babies. I worked with one severely ill cardiac baby who only began to thrive when mom started to feed her hind milk. Unfortunately in her medical circumstance she needed increased calories to grow.  We could have given her high calorie formula with all of its attendant problems. The physicians tried fortified breast milk and the baby could not tolerate it. Finally, reluctantly, they agreed to try hind milk and this baby began to grow.  It was wonderful.  She could not tolerate the amount of "unengineered" mom's milk that would have allowed her to grow. Lactoengineering saved this baby's life.

Kathy Boggs, RN, IBCLC
Mountain View, CA