I woke up this morning with the tiniest sore throat and headache. I immediately did everything in my power to eliminate them including eating cayenne and taking echinacea and vitamin c, and felt back to normal about halfway through the day. We stayed away from the hospital anyway which was horrible but at least we had board games, crafts, a new Netflix show to enjoy and our favorite cafe down the street which included a nice walk in the rain to get there.
I called in several times to check on Milo and in the evening they mentioned that they had started him on Human Milk Fortifier (a cow based feed supplement given to premature babies as a matter of course). I asked the nurse on the phone some questions but she told me the doctor would be a better person to answer my questions the next day. I hung up and immediate began researching Human Milk Fortifier risks and benefits. After 2 or 3 articles I had a bad feeling so I called back and asked them to stop fortifying until we had a chance to discuss it with his doctor. He received two feeds with the fortifier and ran out of fresh milk to boot so they switched him to frozen colostrum which we were hoping he would get anyway.
Summary of the below rant: I couldn't find any evidence that milk fortifier would be beneficial for Miles and will consult our doctor and dietician tomorrow.
I spent the rest of the evening (and into the night) reading studies done on premature babies using the milk fortifier. It is touted as increasing short term growth, improving bone mineralization, and helping babies get the calories they need. The studies said that mother's milk, while sufficient for term babies, does not have the calorie content needed for preterm infants to match in-utero growth rates at the volume the preemie stomachs can handle. After reading through the actual studies conducted however, I found that 1) no long-term bone growth mineralization was indicated from the studies, 2) none of the research concluded that in-utero growth rate was necessary or even desirable. So while the fortifier looks like it will help him gain weight quickly and potentially get discharged from the hospital earlier, it seems to come with increased health risks (childhood diabetes, intestinal issues, and others) that I couldn't justify from the results of the studies available online. I was anxious to speak to his doctor in the morning to see if there are any conclusive studies of positive long-term benefits of the fortifier to which I didn't have access.
Another concern of the fortifier is that it is composed of high fructose corn syrup and flavoring in addition to the vitamins and minerals (granted the studies mentioned several kinds of fortifiers and the nurse was unable to tell me what kind they were using) ****UPDATE: his fortifier contains corn syrup solids which are different than high fructose corn syrup and no flavoring in this version**** and the base ingredient comes from cow milk which can cause problems in babies who are lactose intolerant or having trouble digesting the larger milk enzymes. Though these risks are small, if there is no long-term benefit, I can't rationalize making this decision for him. Long story short, I learned a lot about milk fortifier and none of it made me feel more comfortable giving it to my baby despite the nurse's insistence that they highly recommend it for all preterm babies. I am curious to see how the doctor will address these concerns in the morning.
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