But there is no good evidence to prove that, whereas there is evidence that babies who grow faster than the premature baby on breastmilk has problems later in life with higher levels of "bad" cholesterol, higher blood pressure, insulin resistance (which may be an early finding of type 2 diabetes) and overweight. These studies were done in premature babies given a) just breastmilk b) breastmilk plus banked breastmilk or c) breastmilk plus preterm formula. The babies who got the preterm formula did grow faster and bigger but there was a price.
How can the baby be fed without using fortifiers? Well, first of all, some babies will need fortifiers, true: really tiny babies and babies whose mothers are not able to express enough milk. However, fortifiers are now being made from human milk (breastmilk) but admittedly they are not easily available yet and are very expensive as well. There is no reason fortifiers need be made from cow's milk. However, most premature babies don't need fortifiers because most premature babies are "big" premature babies.
One way avoiding the need for fortifiers in some premature babies, I learned when I worked with premature babies in Africa, was to give them more breastmilk than what is "allowed" in NICU's. True, these babies were not like babies in NICU's in affluent countries; they were bigger, not as sick and needed not more than a little oxygen to survive.
3. Myth -- Premature babies cannot go to the breast until they are at 34 weeks gestation...
This is simply not true. Work in NICU’s friendly to breastfeeding, especially in Sweden, have shown that babies can start taking the breast even by 28 weeks gestation and many are able to latch on and drink milk from the breast by 30 weeks gestation. Indeed, some babies have gotten to full breastfeeding by 32 weeks gestation. This means breastfeeding, not receiving breastmilk in a bottle or tube in the stomach. With Kangaroo Mother Care and early access to the breast, it can be done elsewhere as well.
Of course, every baby is different and some babies may take longer depending on whether they were sick with respiratory problems or other issues, but waiting until the baby is 34 weeks gestation before trying the baby on the breast is using the bottle-fed baby as the model for infant feeding.
See the following articles or refer your doctor to them:
• Nyqvist K. The development of preterm infants’ breastfeeding behavior. Early Human Development; 1999;55:247–264
• Nyqvist K. Early attainment of breastfeeding competence in very preterm infants, Acta Pædiatrica 2008;97:776–781