I am having a major battle with physicians in our hospital (CHOP) against the
use of HMF for non-premature infants who are receiving BM either by a feeding
tube or bottle.  I work in the cardiac intensive care unit with very sick
full term newborns who have undergone surgical repair of cardiac anomolies.
 It is often 3-4 weeks before they are discharged to home.  They are fluid
restricted so in order to get enough calories to grow the breastmilk needs to
be fortified to 24 or 27 calories per ounce (unfortified BM is usually around
20 calories per ounce and so is regular ABM).

I am planning on contacting the manufacturer for additional studies (there is
nothing in the literature).  My primary concern is the very high level of
vitamin D, vitamin A, calcium and phosphorus which are needed for bone
accretion in premature infants.  I prefer to fortify BM with powdered infant
formula or microlipid.

Any other thoughts or ideas on fortifying BM would be greatly appreciated.
 Thanks.

Rachelle Lessen, R.D.