Katie,
Good question. It looks as if *all* the babies in the recently reported
Schanler study were indeed receiving human milk fortifier. In fact, the
babies who were receiving the *most* human milk were only getting 100
ml/kg/day of their own mothers' milk, plus 60 ml/kg/day of HMF. It seems
as if the three groups of babies in this study were fed:
* mothers' milk plus HMF
* donor milk plus HMF
* pre-term formula
So really, the study compared mixed-fed babies with mixed-fed babies and
exclusively formula-fed babies.
I'm left wondering how the staff assisting the mothers were not more
careful to maximize their breastmilk supplies? If a baby weighing, say
1000g were only receiving 100 ml/kg/day of his own mothers' milk, that
would mean that the mother was only expressing/pumping 100 ml/day (or, say
up to 300 ml/day by the time the baby achieved a normal sort of full-term
weight) - this is grossly inadequate. Surely there could have been
provision of better lactation management for these mothers than that??
In my experience 160 ml/kg/day is not enough total milk for a stable baby
to gain the catch-up weight everyone would probably like for these kinds of
very low birth-weight babies - once they were out of danger they could have
received far higher quantities of their own mothers' milk - say up to 280
ml/kg/day. Before they were out of danger, they would surely have been
receiving lower intakes and would have - logically - been less at risk for
infection if not exposed to "foreign" substances - so that HMF would have
not been needed until they had stabilized??
I'd really be interested to hear what kinds of protocols are in place
justifying the use of HMF??
Pamela Morrison IBCLC
Rustington, England
[log in to unmask]
At 16:10 12/08/2005, you wrote:
>Date: Fri, 12 Aug 2005 02:09:30 -0500
>From: Kathryne Bredbeck <[log in to unmask]>
>Subject: Re: Schandler study--donor milk
>
>On Friday, August 5, 2005, at 06:41 PM, Dr. Wight wrote:
>
>>2. Schandler's study also concluded that infants did not grow as well on
>>pasteurized donor milk - conclusion: why use donor milk!
>
>
>Dr. Wight, Is this your conclusion or Schandler's?
>
>Has anyone been able to find out if the babies were indeed receiving HMF
>in this study?
>
>I'm guessing someone will tell me that if I did a little more digging, I
>may find this information myself? Would you send me a link?
>
>Katie Bredbeck
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