While this is a very interesting and important question, I don't think there
is a surefire answer.
I understand exactly the situation. The baby might only use 24 mls of
colostrum in a day, for example, (or less) and after a week only used
approx 168 mls of his mother's colostrum (approx 6 ounces). In a normal,
term infant, the infant would
by then be onto transitional milk (direct from breast) and onto mature milk.
The very small nicu
infant could conceivably be on colostrum for a couple weeks, if his mother
had an abundant supply of it in
the early days.
We know that mother's milk "comes in" at different times and amounts, and
that even healthy term infants are not all the same in how/what/when the
milk is changing for them.
Do we know exactly how the preterm infant's gut matures? Do we know what is
more important to a premie --
higher protein and immunoglobulins and gut closure from colostrum vs the
progression to more lactose etc.?
I don't know, and I don't think anyone else does.
Just on the face of it, it would seem the colostrum is highly valuable, and
why not use it in exactly the
sequence that it was expressed? In the absence of research, that is what
makes the most sense to
me. I don't see how it would be harmful, and it would give baby to gradual
change that any other infant would get.
Otherwise, you would have to arbitrarily decide what milk you would feed
baby, on what day, etc.
You might want to contact Dr. Paula Meier at Rush Chicago nicu, or lactnet's
Dr. Nancy Wight in
San Diego at Sharp Mary Birch, I beleive, who may have more to offer.
Laurie Wheeler RN MN IBCLC and former nicu head nurse
Mississippi USA
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