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Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 17 Sep 2003 19:07:13 EDT
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In a message dated 9/17/2003 3:25:55 PM Pacific Standard Time,
[log in to unmask] writes:
There is controversy in our NICU about whether this is a valid practice.
At times, mothers will run low of milk, choose to wean to formula, or
simply forget to bring more milk to the hospital.  Especially in instances
when a mother is running low of her pumped milk and may be 'drying up',
would you recommend mixing it with formula to 'extend' the benefits of the
formula rather than giving all the breast milk before switching to all
formula?

You are correct - there are two issues:
1. What does the formula do to the breastmilk?  There is some literature to
suggest the anti-infective properties are somewhat compromised - but still
better than ABM alone.  There is also some evidence that Calcium and fat
absorption may be decreased with fortifiers (similar to formula), although an older
study suggested formula mixed with breastmilk enhanced fat absorption because of
the lipase in the human milk.
2. What are the risks and benefits of mxing to stretch the EBM vs the cold
turkey switch approach.  Need to consider feeding tolerance as well as
anti-infective and nutritional concerns.

Answer: There is no research to suggest one way is better than the other.
Although I have no problem going from PIZZA to ice cream 3 hrs later, a preterm
or even term baby might.  I usually end up s-t-r-e-t-c-h-i-n-g the milk.  Would
like to hear what others do.
Nancy

Nancy E. Wight MD, FAAP, IBCLC
Neonatologist, Children's Hospital & Sharp Mary Birch Hospital For Women
Medical Director, Sharp HealthCare Lactation Services
San Diego, California, USA
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