I have just returned from the New Mexico Breastfeeding task Force Meeting in
Albuqurque where I presented (among other things) "Fortifiers and Vitamins:
Needed or Not?" after a review of the literature. Although no knowledgeable
neonatologist LIKES giving a fortifier made from cow's milk proteins to any
infant, there is simply not enough protein, calcium, phosphorus and sodium,
even in "preterm" milk, to meet the needs of infants less than 1500 gms.  If
you push volumes up to 250-300 cc/kg/day like they do in Europe (we don't do
it because of the research on BPD, PDA and xs fluids), you can meet some
needs (protein and vits) but there is no way to get enough Ca and Phos with
physiologic volumes.
Nancy

Nancy E. Wight MD, FAAP, IBCLC
Neonatologist
Medical Director, Lactation Services
San Diego, CA, USA

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