>I would say that this issue should be brought to your hospital ethics
>committee. References are needed by those who are performing the
>intervention, in this case, introducing an artificial baby milk to >babies
>who do not need it....this goes against the AAP guidelines, as well as
> >many
>other well-prescribed evidence-based practices for in-hospital care of
>newborns.  The people who do this need evidence....to support it, >rather
>than you needing evidence to refute it.  Those in favor need to show >the
>evidence proving that it is not harmful, which, I am afraid, they will >not
>find.

Before going to the hospital ethics committee, I think it is necessary to
find out exactly which babies are being prescribed Human Milk Fortifier
(HMF) and why.  There are very good and valid, research based reasons why
HMF is used in the pre-term population and significant recent research to
show that it is beneficial to use on now term (previously pre-term) babies
post discharge.  Are the term babies being prescribed ex prems? or very
small babies who may possibly benefit from catch up growth? or good sized
healthy babies born and term? (in which case it is definately
contra-indicated and the issue certainly needs addressing). There are also
huge question marks about suggesting low iron formula as an alternative as
the origanal author of the post suggested, particularly if the parents
switch to its exclusive use, because of the risk of anaemia.

Being armed with the relevant research based information is empowering and,
if a case needs to be argued credibility, it is enhanced because the
homework has been done.  As I posted yesterday the research by Robert
Schanler will probably give the information  needed.  People can access a 10
day free trial to mdconsult at http://www.mdconsult.com and you will find
lots of his research there.  (this is a subscription site but you can gain a
10 day free trial which includes over 50 online journals, there is a
significant amount of current BF info as well)
Marian Rigney RN and IBCLC candidate


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