Nancy Thanks for writing. I wanted to point out again that I was not referring to neos when I said "practitioners" but rather the peds and family docs I currently work with. I'm not trying to bash them either as their focus is not primarily neonatology. Unfortunately, I don't see evidence of their using current best practice and I sincerely have come to the conclusion that many just don't trust that breastmilk is a calorie rich and nourishing substance. I totally agree with your statement "Assuming that all will be well if we just use enough breastmilk alone is just as much an assumption as all fortifiers are needed." I said the same thing in my last post, we definitely need more research. We can't assume anything. But it is an area that could show promise, particularly with later date premies. Please note that in my comments I referred to 32+ wk'ers. I'm sure you and I can agree that very sick and VLBW babies are a whole different scenario. Smallest baby I ever cared for was about 380 gms, IUGR 28 WKS. She did survive without much sequalae (retinopathy) last I saw her at a reunion. I have the utmost respect for neonatologists, in general. Best regards, Laurie Laurie Wheeler RN MN IBCLC Mississippi USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome