In a message dated 9/10/02 7:54:36 AM, [log in to unmask] writes:

<< I was curious if anyone has separated breastmilk by centrifuge, taken
> off the fat and used the milk + additives for infants with chylothorax
> vs. using only portagen?  We have been contemplating doing so here and
> wanted to know if anyone else has done so already and what the outcome
> was. Thank you for any information.
> Tracy Ruvolo, MS, RD, CBE
> Neonatal Nutritionist
> Phoenix Children's Hospital >>

In case Trish Whitehouse misses this post (Bobby's mom) You can check the
archives for information and a way to get in touch with Trish. I did just
that several months ago when we had  a post op cardiac baby with chylothorax
and parents wanted to use only breast milk. Trish and her husband sent me an
elegant procedure for fractionating large quantities of mom's milk and we
geared up to do it.  We were searching for donation of a clean centrifuge and
had even convinced the powers that be (cardiac surgeons) to let us try. They
pretty much threw their hands up and said, "do what you want", but that
worked for us.  Fortunately for the baby, her chylothorax quickly
spontaneously healed and she was able to get mom's whole milk so we never
instituted the procedure, but we have it available and may need it again.  In
a nutshell, milk is centrifuged, all fat is skimmed and medium chain
triglycerides are added. I believe it is the long chain triglycerides which
are the problem.  So-- this is where I can put in my plug for LACTNET. I
searched the archives for chylothorax, found info from Trish, emailed her and
soon had both an  e mail and  telephone relationship. She and her husband
went above and beyond to get the procedure to us on the West Coast and it was
beautifully written and illustrated.  I'm dying to use it.  Where else could
I have gotten such personal information and help?  LACTNET is great and so
were Trish and her husband.

Kathy Boggs, RN, IBCLC
Mountain View, CA

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