I attended our neo's weekly meeting today. They are trying to come up with guidelines on the use of human milk fortifier for preemies. I need some up-to-date info quick! Today the Mead Johnson presented her "argument" tomorrow it is the Ross guys turn! I can't believe they are making decisions based on what the sales reps tell them but that's another issue. We have a new dietician who is very involved in all of this and willing to listen to my input. The following is a summary of her recommendations to the neo's. 

1) Human milk will be the feeding choice of premature infants.
2) Infants <1500 gms will get human milk supplemented with human milk fortifier after 2 weeks of unsupplemented preterm human milk. Serum calcium, Phosphorus, and Alkaline Phosphatase levels to be monitored carefully.
3) Once infant is 1800 gms human milk will be supplemented with 22 cal/oz powdered formula.
4) Infants weighing 1500-1800 gms at birth will get BM supplemented with 22cal/oz powdered formula for 3 feeds per day following a breastfeeding until infant is 8-12 weeks corrected gestational age.
5) Alternative feeding techniques (ie SNS) are to be encouraged when appropriate
6) Infants >1800 gms birth weight will receive exclusive human milk feeds and a daily multivitamin supplement

I know how all of this sounds and I am not happy but I need some info as to what other neo's and NICN units are doing.  Does anyone know how to get in touch with Paula Meir. Our dietician is very interested in using hind milk with the VLBW babies. 

In the past they have used human milk fortifier on a case by case basis as they felt it was needed. Usually with our very small preemies. Keep in mind, those of you who may want to rant about this that we are talking about some babies who are 1# (or less) at birth and 25-29 weeks gestation. The Neo's want to hear more from me than just "breastmilk is best"

Holly McSpadden IBCLC
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