In a message dated 8/24/2005 9:01:45 PM Pacific Standard Time, 
[log in to unmask] writes:
Nancy, are you saying that the failure to thrive/grow appropriately which
prompted the switch of some babies in the Schanler study from DM to formula
was caused by a lack of protein?  I thought all groups were being fortified,
so that wasn't the problem.  Did I misunderstand?  I thought they weren't
growing because they weren't getting enough calories?  I understand the
difference between needing more calories and needing more protein, calcium
and phosphorus.  I didn't think that was the issue with these babies and if
it was, why didn't they just fortify the DM?
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I don't know what caused the FTT in Schanler's babies.  The donor milk was 
fortified with the same human milk fortifier used with mother's own milk. Donor 
human milk has much less protein than a mother's own milk as donors tend to be 
mothers of healthy term infants between 3-12 months of age.  Schanler tried 
to maximize the protein by using "premie milk" from the milk bank, but even 
that is milk from mother's of older premies, with less protein.  The calories may 
also have been lower in the donor milk.  I don't know whether they analyzed 
the content of the milk they used.

One attraction Prolacta will have for neonatologists is that they will 
standardize their product with nutritional information on the label.  One benefit 
for healthy babies, but drawback for ill premies, is that all human milk 
components are highly variable!

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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