Nancy,
My comments were not intended as criticism of neonatolgists or the many
dedicated health professionals who work in NICU's.  My comments are directed
towards what we believe to be true and why we believe it to be true.  And how
much that may or may not be influenced by the infant formula industry.

What I am questioning is the belief that preterm infants grow better with
fortifiers. You certainly are right that there is ample research but much of
that "research has been based on work done using pooled milk samples
collected from women whose infants are full term and many months old."
(Lawrence, Breastfeeding Guide for the medical profession. p.408)  Lawrence
states that "the source" of human milk is important to understanding
nutritional adequacies.  Auerbach and Riordan say basicly the same thing, the
studies we have in this area have not been done on the fresh preterm milk a
mother might provide but rather on donor milk that due to storage conditions
could be substantial changed.

But why do we have to examine the milk??  Why can't we examine health
outcomes of infants??  I believe that a study on health outcomes of preterm
infants fed human milk alone versus human milk with fortifiers would be
worthwhile.

The other painful question I have is that sometimes research is wedded to
industry.  For example, Lucas is often cited in regard to research on preterm
infants and their need for fortification.  Yet, Lucas has a patent in the US
patent office, patent  # 4753926 called "Infant foods."  The assignee to that
patent is Farley Health Foods (owned by Heinz) and it was filed in 1987.
This patent is on a food supplement for preterm infants.  So in my mind, I
find myself wondering about the why of this patenting.  A level of doubt has
entered my mind that I can't seem to shake.

From reading the many patents it is obvious that infant formulas and human
milk fortifiers are using genetically engineered food components.  Thus, our
most vulnerable population is exposed to new ingredients.  We do not yet know
the ramifications of using these new substances.  Some of the risks according
to many consumer groups opposed to genetic engineering of our foods is that
of increasing the risk of allergic reactions, decreased effectiveness of
antibiotics, possible deletion of important food elements, new and higher
levels of toxins, etc.

Valerie W. McClain, IBCLC

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