At 05:21 PM 5/2/01, you wrote:
>A nurse writes:
>
>"She's absolutely livid, since she's convinced the formula is what
>caused the NE, "
>Having worked an NICU, or Special Care NSY for the last 20 plus years, I
>must congratulate this mom on her discovery. For years doctors and
>researchers have strive to fine the one cause, of NEC and here this mom
>seems to have done so in just one day.
>
>I thought this was a little harsh. Dr. Aurelio (Sonny) Rivera,
>neonatologist and one of the founders of the Mother's Milk Bank of Austin,
>refers in public talks to formula as being "NEC powder." He is convinced it
>is the single most important factor in NEC in premature infants. That's one
>of the main reasons he founded the milk bank. He insists that all babies in
>his NICU get mother's milk -- either their own, or from the milk bank.
>
>Kathy Dettwyler
And the real point is they gave this baby something that carries known
risks *against the mother's wishes*. Most treatments require consent, don't
they?
>NEC: Etiology is unclear and mulitfactorial. 3 mechanisms suggested as
>pathogenesis 1) intestinal ischemia, 2) bacterial colonization, 3) enteral
>feedings. Onset is usually between 3-10 days of life. Incidence: 1-10 %
>of all admissions to the NICU; approx 90 % of cases occur in
>preterm. Sporadic and in clusters.
>
>
>Now mom may have latched on (no pun intended) to # 3 and be partially
>correct, but ask your self this, if it was just the formula, why didn't
>the other twin get NEC? Yes "Breastfeeding may be partially
>protective" but look at the other causes. If the infants required O2
>then they were susceptible. Is it possible that the staff ran out of
>breastmilk / colostrum, since she was feeding two? Nurses are people too
>and do make mistakes. Do you want to Crucify them all? I understand
>Kathleen's vent and concern for a dear friend, but the doctors and staff
>are also (I assume) concerned for her friend's twins. Remember "Preterm
>infants do not follow the Normal pattern of Full term infants".
Don't we know that formula feeding changes the bacterial colonization? My
understanding is that supplementing breastfeeding with anything, even in a
small quantity, changes the state of the intestine. And the reason the
other baby didn't get NEC from formula is the same reason that even during
an epidemic, some people don't get sick. They are not the same person, and
they have different immune system statuses at any given time.
Cheri Singleton
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