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Subject:
From:
Marian Rigney <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 16 Jul 2002 23:33:35 +1000
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Hi All
While I resprect Carol Bartle's and  Pam Morrisons point of view regarding
fortifification of EBM with human milk fortifier (HMF), I believe the issue
of optimal nutrition of the pre-term infant is a complex issue--and yes no
one has all the right answers yet.  There is continuing research into  and
refinement of HMF.  The HMF in 2002 is far better than a few years ago and
will continue to improve in the future to better meet the needs of preterm
babies. Hopefully there will also be further research and adoption of
alternatives such as lactoenginerring of expressed breast milk. One possible
alternative could be to process donated human milk and eliminate the risk of
cow's milk allergy altogether.  Simply giving very large volumes of EBM (for
extra calories and catch up growth) may not be the best alternative because
in the very preterm baby they are then at increased risk of developing
patent ductus arteriosis.  The bottom line is that doctors and
neonatologists in SCNs and NICUs  prescribe  HMF because they believe the
benefits outweigh the risks and that they have  research data to back up
their decisions.I could also give a myriad of articles and studies
supporting the use of HMF but a medline search will give the  numerous
references rather than me listing a page full.  I urge you to keep an open
mind when you are dealing with parent's of premature babies whose EBM is
modified to meet their unique nutritional needs.  These babies are still
getting enormous benefit from the EBM and the need to provide EBM at all
costs should be unquestioned. From my working with premature babies over the
last 20+ years, using HMF and taking the time to do extensive reading on the
topic I personally support its use in the preterm population.

Marian Rigney RN (who is beginning to get nervous about THE EXAM and wishing
it was over)


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