With apologies to those who have read this before, I just wanted to repeat
that Humam Milk Fortifier is unknown in this country, and the pre-term
babies grow just fine, the very tiny ones receiving Vit D, and later iron,
in addition to their own mother's expressed breastmilk.  They are usually
discharged home, exclusively breastfed, when they reach l800g and this is
usually well before their due dates. While these babies receive EBM the
paediatricians will increase the quantities up to 220ml/kg/day and more.
Once they are breastfeeding they can take as much as they want.  One of the
babies I worked with started gaining 65g/day at about 34 weeks, far in
excess of even the "normal" 30g/day for a full-term baby.

Surely a baby who is well/big enough to be discharged has no need of any
kind of "fortifier"?

The other day I bumped into one of the 33 week gestation babies I had worked
with six years ago.  He was wearing the school uniform of a very exclusive
private school, where competition to be accepted is fierce.  I asked his
mother if she had "connections" with the school enabling him to be accepted.
She said no, he had just passed the entrance exam.  I know this school has
places for only 3 or 4 such children each year and that they have to compete
with 150 others.  This means that this child, now a fairly *tall* 6 year
old, fed nothing but his own mother's milk as a pre-term, is in the top 3%
for cognitive ability.  It was hard, but she did it!

For myself, I'm not persuaded by Richard Schanler's article in JHL, that HMF
is essential.

Pamela Morrison, IBCLC
Harare, Zimbabwe

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html