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) _________________________________________________________________ Send and receive Hotmail on your mobile device: http://mobile.msn.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html