This has been a very enlightening discussion, and I sincerely appreciate the knowledge, professionalism, and passion from the likes of Valerie, Nancy, Barbara and others. I accept that expressed milk, including hand expressed and (probably more likely) pumped milk, could be contaminated. I accept that premies, (especially micropremies) and other sick neonates, are at highest risk from said contamination. I agree that getting babies to direct breastfeeding would decrease these risks. What I want to know is this: what about the kangaroo mother care model? I have read about and heard talks about and seen videos of very small premies being kangaroo-ed. It seems they are taking all feeds at breast or maybe some that are hand expressed and cup fed. The key seems to be baby-wearing 24/7 with ad lib small feeds, in continuous contact with mother. Wouldnt' this greatly decrease these contamination risks? Remember I am very familiar with the USA NICU environment and culture, having been a level 3 nicu nurse/head nurse for 11 years at a tertiary center (Ochsner, New Orleans) and of course I currently work with nicu babies as an LC. Mother/baby separation is the norm. Mothers and babies are together for only a few minutes for a few feedings each day, even for basically well "feeders and growers." I agree with Barbara that premies are not competent feeders and often fatigue, etc and need comp feeds, but...what if they were truly cared for in the KMC mode? What would their immune status be? Would they be colonized differently etc? Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ MSN 8 helps eliminate e-mail viruses. Get 2 months FREE*. http://join.msn.com/?page=features/virus *********************************************** 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