Dear Lactnet Friends:
The fabulous life saving technology used in Level III and IV NICUs here in
the States is fabulously expensive. Extracorporeal membrane oxygenation
treatment adds $70,000 to the cost caring for an adult who needs it; I
don't know how much more it adds to the cost for a premature infant. Jet
ventilators are also expensive.
Why bother using all this expensive technology to keep premies alive if the
plan is to use bovine protein because it is cheap? NICU staff often say
that, "human milk is so expensive; human milk products are terribly
expensive." So HMF is used (bovine source) because it is cheap (sometimes
free) and the babies get NEC and intestinal obstruction; sometimes they
die.
I don't get it.
Would you be alright receiving cow blood in an emergency ward if they were
out of human blood?
Here's yet another case report. I don't like their conclusion; I think this
mess could have been prevented if the baby had received nothing but human
milk proteins from the beginning.
Pediatr Int. <http://www.ncbi.nlm.nih.gov/pubmed/23409991#> 2013
Feb;55(1):114-6. doi: 10.1111/j.1442-200X.2012.03630.x.
Development of fatty acid calcium stone ileus after initiation of human
milk fortifier.
Murase M<http://www.ncbi.nlm.nih.gov/pubmed?term=Murase%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Miyazawa T<http://www.ncbi.nlm.nih.gov/pubmed?term=Miyazawa%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Taki M<http://www.ncbi.nlm.nih.gov/pubmed?term=Taki%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Sakurai M<http://www.ncbi.nlm.nih.gov/pubmed?term=Sakurai%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Miura F<http://www.ncbi.nlm.nih.gov/pubmed?term=Miura%20F%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Mizuno K<http://www.ncbi.nlm.nih.gov/pubmed?term=Mizuno%20K%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Itabashi K<http://www.ncbi.nlm.nih.gov/pubmed?term=Itabashi%20K%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
, Toki A<http://www.ncbi.nlm.nih.gov/pubmed?term=Toki%20A%5BAuthor%5D&cauthor=true&cauthor_uid=23409991>
.
Source
Departments of Pediatrics Pediatric Surgery, Showa University School of
Medicine, Tokyo, Japan.
Abstract
We report a case who was born with extremely low birth weight infant and
had experienced abdominal operation for necrotizing enterocolitis,
eventually developed ileus due to fatty acid calcium stones after giving
human milk fortifier. He had developed necrotizing enterocolitis on day 30
of his age, such that we performed enterectomy and ileostomy. He could not
tolerate enteral feeding fully, because intestinal fistula infection was
repeated. Although we administered hindmilk, he grew up slowly and he
suffered cholestasis as well.
We performed end-to-end anastomosis to prevent fistula infections on day
87. After this operation, breast milk feeding volume was increased easily.
However, we started to add HMF of half-strength on day 124, because his
body weight gain remained very poor. And we confirmed to intensify the
ratio of HMF full-strength on day 128. After that his abdomen had distended
on day 131. As there is no effect of conservative therapy to occlusive
ileus, we did emergency laparotomy on day 139. Intestinal calculi were
impacted at anastomic portion. Although all stones were removed, he died on
144 days due to disseminated intravascular coagulation and renal failure.
Calculi analysis revealed that all of them were fatty acid calcium stones.
There is no report about like our case. We speculate that the construction
of fatty acid calcium result from either high concentration of
calcium/phosphorus or rapid increase in the fortification. We could have
prevented this case happened by slower increment of fortification.
warmly,
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy*
www.breastfeedingalwaysbest.com
https://www.facebook.com/nikkileehealth
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