Although I think there are a lot of things that could have been done differently, I think it is important to remember this is an appropriate medical use of formula (use with preemies whose mothers can't/aren't producing enough milk, to increase nutrition of bm for preemies). Villifying all use of formula no matter what is not helpful to fixing this specific problem--which involves the lack of an appropriate sterile product for this particular high risk use. For many preemie moms, unfortified bm is simply not an option, whether due to the specific calorie needs of the baby or because it is very hard to pump, with no nipple stimulation and under stressful conditions, enough milk to meet the needs of a preemie to gain well. It is also, obviously, innappropriate to be fortifying without informing the mothers. But, I can see why it may not occur to the hospital; I mean, no one told me what type of IV nutrition my baby recieved. I suppose it could be a matter of where do you draw the line on giving every piece of information versus informed consent.
I think there is no excuse for powdered formula to be contaminated; there have to be ways to sterilize it, but it is probably too expensive or inconvenient as far as packaging is concerned. Liquid HMF would seem to be the answer as it is sterilized, but then the liquid volume is increased, so to control for volume, the amount of bm a baby could recieve might be decreased overall (to get 22 calorie/oz mix, for example, would require equal parts bm and 24 cal/oz liquid fortifier; if you needed a higher calorie milk, the amount of bm would be less than the amount of fortifier). Perhaps the solution would be an ultra concentrated liquid that is therefore able to be sterilized, but minimally increases the overall volume of bm.