I find this quite extreme starting HMF on day 4.Whilst we do use hmf in our unit we generally give the babies a chance to grow with just having mum's EBM. Another thing is that most of our micro-premmie would start on TPN & Lipids plus vitalipids via a umbilical venous catheter or central venous line.Feeds are grade up as baby tolerates,depending on gut absorption,to 180mls per kg when TPN etc is stopped and baby just has EBM.We don't usually add HMF until babies are over 1-1.8kg and showing evidence of not gaining weight .It is stopped once they are over 2-2.5kgs and constantly gaining weight. The only time we leave HMF going past this stage if the baby requires extra calories but due to some physical reason shouldn't get it through extra fluid (EBM). what was the reason for starting HMF so early in this EVLBW neonate. Anne Clements RN EM BNS Brisbane QLD Australia *********************************************** 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