In reply to Barbara Ash's questions: Yes, it is likely that so-called human milk fortifiers would cause similar problems to artificial milk, since the fortifiers are not made of human milk, but of cows milk. Good question you raised. Would the MDs and RDs like to add? 2) Re; nipple shields, if you have had difficulties with their use in premies, now is the time to think about sharing that experience in a case report (or case series) and submit to JHL. Deadline is October 1, 1995 for such documents to be considered to the special Theme issue for Setp. 1996 on nipple shield use/abuse/effectiveness/risk, etc. Hint hint Write me privately if you wish additional information. Def. of LC service: "We are all faced with a series of great opportunities brilliantly disguised as impossible situations." Kathleen G. Auerbach,PhD, IBCLC - [log in to unmask]