In my unit, the basis for this belief is a preemie who fails to gain - over
a longer period than a few days, whose sodium levels drop beyond belief and
who fails to progress at a reasonable rate. I'm talking 23 to 28 weekers
here. The ones nature never meant to survive.

You are right about the message that fortifier sends - and of course the
name fortifier was chosen very carefully I am sure. If I have to fortify, I
don't let the mom see me do it, and I make sure she knows that her milk IS
good enough, and when the baby gains I always give credit to the milk.
Sometimes, there just isn't anything else to do - if the mom is not
interested in providing hindmilk, or she is so stressed that she is failing
to eat adequately, or whatever the issue may be, then fortifier may be
needed. It has it's place and it definately isn't suitable for all babies! I
also agree that we do not know the longterm effects - as with the new
"enhanced" formulas, what long term studies are there?

We live in a world now where everything is engineered to death - there used
to be things like CLA in beef because cows were grass and hay fed - now we
feed them grain or engineered feed (Purina - another Nestle product!) and so
there is no CLA. Our other foods contain things they are not supposed to and
don't contain the things they should anymore. So where does this leave
breastmilk?

To say that all mothers milk is all every baby needs would be fine in an
ideal untampered world, but it isn't always the case where you have
intervened for a baby who would not have had the proverbial snowballs chance
of surviving without significant technology. I too hate that the whole body
of fortifier research has been backed by formula companies. But I lack the
funds, the knowledge and the resources to do this reasearch myself as do
most of us I am sure. While I don't trust the formula companies - I do know
what I see in front of me with the babies I care for daily. While this is
anecdotal, it is presently all I have for evidence aside from formula
company funded studies.

Michelle Meeks, RN

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