This is from another listserv.  If anyone can help her out, her
e-mail address is at the bottom of the post.  Thanks.
Debbie
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
     I am curious to find out if anyone else has heard
complaints about the
     Human Milk Fortifier causing GI problems.

     Over the past couple of years, I have heard complaints
from nursing
     about how poorly HMF mixes with breast milk and
resulting intolerance.
     When I conducted an inservice with nursing and
experimented with
     different mixing methods, altered temperature of milks,
etc., I was
     unable to find any problems with mixing - even at cold
temperature.
     But I was still unable to convince some of our nursing
staff.

     Recently, some physicians have stopped using HMF,
claiming that it
     causes gut "concretions" and severe GI problems.  The
surgeon group in
     town has started this and now it is starting to impact the
care in our
     NICU. I have been unable to get information regarding
specifics or
     cases.

     I have one infant (BW 750g) who recovered from PDA
induced NEC (with
     resection) prior to any feeds - was started on breast milk
- Natural
     care added 8 days later (DOL 28). It was clearly stated in
the chart
     that "HUMAN MILK FORTIFIER IS NOT TO BE USED"
Fluid volume has stayed
     at approx. 165 cc/kg/d (22 cal/oz). My concern is that the
protein
     level has been <3.0 g pro/kg for 2 months. The
physicians are refusing
     to check nutrition labs, so I do not know the current
status at this
     point. They feel she has been doing well, so have not
wanted to add
     modulars, supplement with premie formula, or increase
fluid volume.
     Weight gain and growth has been adequate, but she has
severe apnea and
     reflux with feedings and is not able to nipple yet (even
with PT/OT
     assistance) at 38 weeks CGA. This is one case where
HMF (24 cal/oz)
     would have been my preference, but because of the
current "scare" it
     was not used.

     Has anyone had similar experiences or information
supporting the
     avoidance of Human milk fortifier? Any feedback would be
appreciated.

     Thank you,
     [log in to unmask]
     Portland, OR