In a message dated 8/22/2005 9:38:18 AM Pacific Standard Time, 
[log in to unmask] writes:
My question still 
stands as to why this  was done and how can a conclusion be drawn that 
outcomes from the use of donor  milk are not different than those from 
preterm 
formula? It almost  looks like the formula diluted any effect that donor milk 
would 
have on the 2  outcomes measured, late onset sepsis and occurrence of NEC.
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The infants were switched because they were not growing adequately on the 
PDBM plus fortifier.  We don't allow inadequate nutrition for the sake of any 
study.  

I agree that receiving formula may have diluted the effect of the PDBM, but 
remember, the study was not even started until all the infants reached 50 ml/kg 
total milk intake (presumably their own mother's milk), to remove possible 
bias from early morbidities of prematurity.  Early nutrition (ie. what an infant 
was started on) would be even more likely to affect the outcomes.

Intention to treat analysis is still the best way to treat this data per my 
statistics experts. 

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