I am cleaning out files and found my post and question from March. I
never saw a reply, and I'm still curious.

<I have a different slant on combination feeding that I have not heard
addressed, and some questions.

Is my information outdated? I seem to remember hearing that the
lactoferrin is supposed to attack the cell wall of bacteria to remove
iron for the baby's absorption (and kill the bacteria in the process).

Therefore, if breastmilk were consistently mixed in the bottle with
formula, or for that matter, mixed in the stomach by giving formula while
unadulterated breastmilk is still present, the lactoferrin would be
immediately diverted to the iron contained in the formula.

I remember hearing that this would nullify its destructive action on
bacteria plus not capture that cell wall iron for absorbtion.

I realize this is a long way from saying "It will make the baby sick."
And Barb, you are certainly right that we would have to be very careful
how we explain this to mothers. Especially if they see it done in
hospitals and recommended by physicians.

I would conclude that mixing breastmilk and formula occasionally, if the
baby were already being exposed to formula anyway, would do no harm. But
if it were done consistently, wouldn't this rob the baby of a valuable
anti-infective property?

And premature babies, who need that property the most, seem to
consistently be exposed to the addition of HMF to the breastmilk.
Neonatologists, what say you?

Would it not be better to feed pure unadulterated breastmilk alone at
some feedings to retain the anti-infective benefits?

Then when it has had plenty of time to leave the stomach, then feed "the
other white liquid, unenriched with breastmilk" (notice, I did not say
"pure formula") at other feedings, to get the medically necessary daily
nutrient amounts?

The natural process sounds as if it actually takes place in the
intestine, where the E. coli mostly reside. But separating the two fluids
by 2-3 hours would seem to give the breastmilk "lead time" to attack the
bacteria.

Or is there now evidence to prove it doesn't matter all that much? Am I
way "out of the loop", clinging to outdated information?

Jean
****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA>

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