Claudia writes: "We have a neo that has told a mom that she needs to supplement her twins with expressed breastmilk plus powdered human milk fortifier for the next 4-6 months. Baby's were born at 30 weeks, were healthy, never on a vent, and went home 2 weeks ago at appx 36 weeks adjusted gestational age. Has anyone heard of giving the fortifier for this long?" I went to the Central New York Breastfeeding Connection conference in Syracuse, New York yesterday. The subject of the day was BF the premature baby. Kathleen Marinelli, MD (neonatalogist) and Mary Lussiere, RN, IBCLC, from Connecticut Children's Medical Center, presented. From this presentation I learned that, although human milk fortifiers increase calories somewhat, the main reason for using them is to increase protien, calcium and phosphorus levels in the milk to meet the special needs of premature babies. This is to approximate the rate of growth in utero. Once the baby is ready for discharge, he/she is close to or at 40 weeks corrected gestational age and fortifiers are not used because nutritional needs are different. These items were included in the bibliography. I don't know what information the articles, but maybe something here will be the reference you need: Barb Berges BS, RN, IBCLC Rochester, New York Abrams SA, Schanler RJ, Tsang RC, Garza C. Bone mineralization in former very low birth weight infants fed either human milk or commercial formula: one year follow-up observation. J Peds 1989; 1041-1044. Barrett Reis B, Hall RT, Schanler RJ, et al. Enhanced growth of preterm infants fed a new powdered human milk fortifier: a randomized controlled trial. Pediatrics 2000; 106: 581-588. Hall RT, Wheeler RE, Rippetoe LE. Calcium and phosphorous supplementation after initial hospital discharge in breast-fed infants of less than 1800 grams birth weight. J Periinatol 1993; XIII: 272-278. Lucas A, Fewtrell MS, Morely R, et al. Randomized outcome trial of human milk fortification and developmental outcome in preterm infants. Am J Clin Nut 1996; 64: 142-51. Raiha NC. Human milk feedings for premature infants: a historical perspective. In Human Milk for Very-Low-Birth-Weight Infants. Report of the 108th Ross Conference in Pediatric Research. Columbus, Ohio, 1999, 1-15. Schanler RJ, Abrams, SA. Postnatal attainment of intrauterine macromineral accretion rates in low birth weight infants fed fortified human milk. J Pediatr 1995; 126: 441-447. Schanler RJ, Henderson TR, Hamosh M. Fatty acid soaps may be responsible for poor fat absorption in premature infants fed fortified human milk. Pediatr Res 1999; 45: 290A. Schanler RJ, Shulman RJ, Lau C. Feeding strategies for premature infants: beneficial outcomes of feeding fortified human milk versus preterm formula. Pediatrics 1999; 103: 1150-1157. *********************************************** 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