I am a little concerned with the discussion regarding babies who will not  
latch or feed in the early days. While it is important and sometimes necessary  
to use incentives at the breast or small amounts of formula to feed these 
babies  if the mother is unable to express colostrum, doing so with a standard 
cow's  milk based formula can create unwanted outcomes. Babies who have a family  
history of allergies should not be given little doses of allergens which are 
far  more sensitizing than larger prolonged doses. If a baby actually needs to 
be  supplemented and colostrum is unavailable, then an extensively hydrolyzed 
 formula should be used. Isolated cow's milk feedings to breastfed newborns  
should be avoided so as not to sensitize susceptible babies to allergies. 
Nurses  and lactation consultants who wish to do this should ascertain the 
allergic and  diabetic status of both parents and remind them and other clinicians  
that they place these babies at risk for both allergies and diabetes when  
using standard cow's milk based formulas.
 
Marsha Walker, RN, IBCLC
Weston, MA

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