Subject: | |
From: | |
Reply To: | |
Date: | Mon, 6 Jan 2014 18:55:15 -0500 |
Content-Type: | text/plain |
Parts/Attachments: |
|
|
The protocols, table, recommendations by AAP, ESPEGAN, etc. are based on
science and randomized controlled trials (RCT) as well as experience. We
still don't know how a 24 week infant is supposed to grow outside the uterus
- they didn't survive before. We also know that faster growth is not
always better in the long run - eg. to get optimal brain growth and IQ you need
18 g/kg/d weight gain, BUT at this level you increase the rate of obesity,
heart disease, hypertension. What is the best rate of growth and the most
important nutrients, in what concentrations we still don't know exactly
after 100 years of trial and error, then carefully conducted research.
The science took a giant leap with Dr. Zeigler analyzing the body
composition of stillborn babies at various gestational ages (are stillborns the
same as liveborns?) to get the average accretion rates of various macro and
micronutients over the entire gestational range. From there we have
thousands of different studies - some poorly and some well-done. As new
information becomes available the experts revise their recommendations - and don't
always agree.
Preterm and ill infants are very different from healthy term infants, and
have very different nutritional requirements. The age of changing
something, then trying it out (without a RCT) should be at an end, but for formulas
it is still there.
Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, San Diego Neonatology, Inc.
Medical Director, Sharp HealthCare Lactation Services
Sharp Mary Birch Hospital for Women and Newborns
[log in to unmask] (mailto:[log in to unmask])
BREASTFEEDING: The Best Health Insurance
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
|
|