The neonatologist and nurses are simply uninformed.  The VON iNICQ best 
practice toolkit (lead- Dr. E. Ziegler, Univ of Iowa - world class nutrition 
researcher) and the CAN CPQCC toolkits , after reviewing all the literature, both 
came to the conclusion that donor milk was second only to mothers' own milk in 
safety and benefits for preterm infants.  Donor milk is screened and 
heat-treated so it is sterile when shipped. There has never been a reported problem with 
HMBANA donor milk.
 
VON Best practices:
 
    1.  Begin TPN within first few hours of life 
    2.  Begin trophic feeds within the first 3 days of life 
    3.  Manage residuals appropriately 
    4.  Fortify human milk adequately 
    5.  Facilitate post-discharge feeding of breastmilk, including 
fortification
General Considerations: 
¢     Breastmilk is the feeding of choice, including donor milk when mom’s 
own is not available. 
¢     ELBW infants (<1000g) deserve our special attention as they have lesser 
reserves and tend to receive less nutrition than larger infants. 
¢     Protein is almost always the limiting nutrient. 
Also, go to _www.hmbana.org_ (http://www.hmbana.org) , _www.prolacta.com_ 
(http://www.prolacta.com)  , _www.cpqcc.org_ (http://www.cpqcc.org)  and scroll 
down to nutrition toolkits 1 & 2. 
 
1.


 
Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Rady Children's 
Hospital
Medical Director, Sharp Healthcare Lactation Services
San Diego, California, USA



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