Greetings to all LactNet members.  I am a student LC, just finishing the
Breastfeeding Support Consultants course.  I have a few questions relating to
feeding premature infants.

The first relates to bovine-based human milk fortifiers.  Do these
fortifiers, which I understand are used to increase protein, calcium and
phosphorus levels in preterm human milk, cause the same types of problems for
children with allergies or who are prone to be lactose-intolerant that
feeding standard artifical baby milks to a healthy, full term infant might
cause?  (This stems from Lawrence, p. 406-7).

Who is doing research on this topic besides the formula companies?  How much
per ounce does lacto-engineered human-milk based fortifers cost?  Where is it
available (on the East coast)?

The second question concerns the use of nipple/breast shields.  I am
wondering how a soft, pliable breast shield is helpful for a pre-term infant
who has trouble retaining the human nipple in his mouth during a feed.  I
presume that it is something firm for him to latch onto.  Yet this same
infant who has a suck too weak to breastfeed directly on the breast can
consume adequate volumes of milk through the shield.  How can he do this.  I
thought breastfeeding through the shield was more difficult that doing so at
the 'bare' breast.  (Riordan and Auerbach, p. 272 generated this question).

Thanks for your help.