I haven't written to Lactnet for a long time. Sorry about the long post!
Research has only shown short term increases in weight gain, linear and head
growth in preterm babies fed HMF in their mother's breastmilk. Kuschel &
Harding (2001,p.3)in a Cochrane review, stated that there was insufficient data
available to evaluate long term neurodevelopmental and growth outcomes. Ziegler
(2001,p.722)says that fortification of breastmilk has turned out to be much
more difficult than anticipated and that current fortification methods are
inadequate and produce unsatisfactory results. Ziegler also points out that due
to the enormous variability in the composition of breastmilk expressed by
mothers of preterm infants, the risks associated with overloading babies with
excess protein and energy intakes seem unacceptable. I couldn't agree more.
Just because the head grows in size doesn't mean that this is 'normal' brain
growth. It is what's inside that counts in the end, not the size. (So size
doesn't matter in this case!) An ongoing research project(Dr Terrie Inder)
looking with MRI scanning techniques, at the brains of preterm babies without
obvious brain injury, at a corrected full term age and brains of babies born at
full term is producing disturbing results.These preterm brains are 'differently
wired' to the control group babies which has long term implications for health
and development. Even without brain injury these babies are showing signs of
learning difficulties.Evidence exists that early events have a lifetime effect
on the organism. Nutrition behaves in this programming way in animal studies.
Effects include a lifelong impact on behaviour and learning as well as the more
obvious blood pressure, obesity and diabetes etc (Lucas 1998).Lucas also states
in his short paper (in a Nestle Nutrition Workshop Series!)that "extensive
experimental studies of nutritional programming have been conducted, at this
stage to a large extent, on the vulnerable preterm infant". The burden of proof
should be on those who continue to experiment on our vulnerable babies using
under-researched and inadequate breastmilk fortification methods. Don't even
get me started on the massive GM experiment on babies because I also agree that
GM is being utilised in artificial baby milk but particularly preterm blends
and HMF. Lets look more at lactoengineering and producing blends of preterm and
term donor breastmilk suitable for supporting optimal growth and development in
preterm babies. As an extra....Did you know that babies on preterm formula have
a 52% risk of developing offensive stools and sore bottoms?( Bromley 1999,p.9)
What is it doing to the insides?!
Carol Bartle RN,RM,IBCLC,PGDipChAd.
References:
Bromley Patricia(1999). Investigation of the relationship between low
birthweight formula and the incidence of nappy rash, Journal of Neonatal
Nursing Vol 5,No6,7-9.
Inder Terrie (2000 & 2002)Brain Injury in Premature Babies, NZ Health Research
Council Newsletter April & Paper presentation at a 'Storming the Brain'
Conference Wellington NZ June 2002.
Kuschel C.A & Harding J.E (2001)Protein Supplementation of Human MIlk for
Promoting Growth in Preterm Infants, Cochrane review. In the Cochrane Library
3. http://www.cochrane.de/cochrane/revabstr/ab000433.htm
Lucas Alan (1998) Early Nutrition and Later Outcome,Nutrition of the Very Low
Birthweight Infant, Nestle Nutrition Workshop Series, Paediatric programme No
43, Vevey, Switzerland.1-3.
Ziegler E.E (2001)Breast-milk fortification, Acta Paediatrica,Vol 90,
No7,July,720-723.
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