Zena:
 As  Kathy mentioned, many NICU's send their LBW/VLBW babies home with the
suggestion to add HMF or someting like neosure to at least a couple of
pumped breastmilk bottles a day.  The recommendation is based on work by
physicians such as Richard Schanler ( sp?) and can be googled easily.
 What I dislike about this recommendation is that many physicians it
seems, do not use the full information and follow labs  such as alk. phos
to decide when the baby is old enough developmentally to no longer need
the supplements. I have seen an alarming trend  such as the one you are
experiencing with a provider just keeping the babe on fortifiers until a
year with no documented medical need for this practice.
 The Academy of Breastfeeding Medicine has a great protocol  ( I  think
it's listed as  Transitioning from the NICU to home)that reflects much of
the recommendations.  This also provides a great basis for encouraging
providers to monitor the labs and growth an prevent excessive prolonged
use of fortifiers.
Lisa J

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