I am cleaning out files and found my post and question from March. I never saw a reply, and I'm still curious. <I have a different slant on combination feeding that I have not heard addressed, and some questions. Is my information outdated? I seem to remember hearing that the lactoferrin is supposed to attack the cell wall of bacteria to remove iron for the baby's absorption (and kill the bacteria in the process). Therefore, if breastmilk were consistently mixed in the bottle with formula, or for that matter, mixed in the stomach by giving formula while unadulterated breastmilk is still present, the lactoferrin would be immediately diverted to the iron contained in the formula. I remember hearing that this would nullify its destructive action on bacteria plus not capture that cell wall iron for absorbtion. I realize this is a long way from saying "It will make the baby sick." And Barb, you are certainly right that we would have to be very careful how we explain this to mothers. Especially if they see it done in hospitals and recommended by physicians. I would conclude that mixing breastmilk and formula occasionally, if the baby were already being exposed to formula anyway, would do no harm. But if it were done consistently, wouldn't this rob the baby of a valuable anti-infective property? And premature babies, who need that property the most, seem to consistently be exposed to the addition of HMF to the breastmilk. Neonatologists, what say you? Would it not be better to feed pure unadulterated breastmilk alone at some feedings to retain the anti-infective benefits? Then when it has had plenty of time to leave the stomach, then feed "the other white liquid, unenriched with breastmilk" (notice, I did not say "pure formula") at other feedings, to get the medically necessary daily nutrient amounts? The natural process sounds as if it actually takes place in the intestine, where the E. coli mostly reside. But separating the two fluids by 2-3 hours would seem to give the breastmilk "lead time" to attack the bacteria. Or is there now evidence to prove it doesn't matter all that much? Am I way "out of the loop", clinging to outdated information? Jean **************** K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA> *********************************************** 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