Lisa Enger posts about the lower, slower weight gain in the extremely
premature babies in her unit.  It seems that weight gains are slower
now that they are using fortfied donor milk than when babies were
getting formula?  Or is it that these babies are gaining more slowly
than other, larger, older babies?

If the weight gains are so slow that the babies are compromised, it
sounds like some adjustments should be made so their growth needs are
met.  But if this effect is simply the *normal* growth of premature
babies fed fortified breastmilk vs the artificially (and not
necessarily healthily so) accelerated growth of formula fed babies,
perhaps it's the other babies who should give cause for concern.
Recent research suggests that excessively rapid growth in the first
weeks of life is not a certain indicator of good health, and may even
be a predisposing factor for insulin resistance and overweight in
later childhood.

I am most definitely NOT an expert on the management of individual
premature babies, all my knowledge on this topic comes from reading
and not from my own practice which has been on a normal postnatal ward
or with graduates of NICUs who are breastfeeding at term without any
supplementation besides iron and multivitamins.  It is the way the
question is put in Lisa's post that prompts me to ask whether it's
actually the slower-gaining babies who have a problem.

Rachel Myr
Kristiansand, Norway

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