I am confused by this posting:  we need to individualize care to some
extent but also need to protect infants from breastmilk substitutes with
inadequate nutritional content (although some would argue that's all of
them!!).  I would ask the following questions:

1)  Why does the parent wish to supplement breast feeding?  How can we help?

2)  Is there not a supply of expressed breast milk?  Has the mother been
adequately counselled about this?

3)  Why are there breast milk substitutes, some made by the same company,
with high and low iron content?  Surely there is an optimal amount of iron
to offset the detrimental effects of humanized cow's milk (we know that
iron deficiency is endemic in non-breastfed infants in low-income families
in North America and may be associated with impaired neurodevelopmental
outcomes:  in the unfortunate eventuality that such infants are not
breastfed they should be given high-iron substitutes).  To protect at-risk
infants who are denied breast-milk for whatever reason I wonder whether
low-iron substitutes should be withdrawn or be available by prescription
only.  Any of the formula companies listening?

I am still confused.

Khalid

Khalid Aziz
Memorial University of Newfoundland