Heidi,
I,too, would like more information and research to cite on the problems
associated with mixing iron-fortified formula supplements with breastmilk
in one feeding.  I had heard that Abe Parvanta and Bo Lonnerdal are doing
research in this area.  Is it published yet?  "The Breastfeeding Answer
Book" has a few sentences on this topic (p. 515), as does "Breastfeeding
and Human Lactation" (p. 115), but I would be interested in some recent
studies to cite.  This has wide implications.  I had heard that WIC
supplies mothers only with iron-fortified formula.  Is that true?  I am
seeing mothers who are receiving iron-fortified formula at discharge from
the hospital, and unsolicited from formula companies (delivered to their
doors), and who are being advised to supplement breastfed (preemie or slow
growth) babies with this after each feeding.  If a baby is receiving
iron-fortified ABM as well as breastmilk, how widely spaced should these be
to minimize the detrimental effects?  Should we try to get mothers to save
up the pumped breastmilk to give it all in one feeding supplement, and then
use all ABM in the next supplemental feeding, rather than mixing them?  (My
goal, of course, is to encourage all-breastmilk supplements, and eventually
total feeding at the breast).  Would 2 hours separation make any
difference?

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI
e-mail at:   [log in to unmask]