Ginger has asked about the article in the August issue of Pediatrics  
regarding an interesting conclusion that donor human milk offers no advantage  over 
preterm formula for very low birthweight babies. Take a closer look at how  the 
study samples were defined. Mother's milk and donor milk were both  
fortified. 21% of the babies in the donor milk group were switched to preterm  formula 
due to insufficient weight gain but were kept in the donor milk group  for 
analysis! Hello there!!!! Mostly this study looks at the difference in short  
term outcome of infants receiving various amounts of human milk mixed with  
various amounts of fortifiers and formula. They switched the brand of fortifiers  
part way through the study from one known to contain a high iron content that  
significantly reduced the anti-infective properties of human milk to a 
different  fortifier with less iron. They totally ignore the fact that using donor 
milk  avoids the use of any powdered formula which is not sterile and which the 
FDA  has warned not to use in the NICU. The fortifiers are powdered and 
contain cow's  milk protein, iron, and are not sterile.
 
As far as I can tell the donor milk group was a mixed group of infants fed  
variously fortified donor milk and preterm formula. Do we wonder why the short  
term outcomes are questionable? Too bad there was not a clearer delineation  
between study groups.
 
Marsha Walker, RN, IBCLC
Weston, MA

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