Dear lacnetter:

In our neonatal unit for the sick babies we encourage the mothers to
breastfeed. Recently, we have two babies with cholestasis. One is a preterm
baby who had received a long term total parenteral nutrition and the skin
became dark yellowish progressively. When he received total breastfeeding,
the liver function kept on impaired and the body weight gain was poor. The
staff changed the feeding to Prota--(A formula contains a lot of midchain
triglyeride which is easy to be digested during liver and biliary tract
disease) and the cholestatsis got improved and the body weight increased.
When I suggested to shift back to breastmilk, the body weight stop
increasing. Even when we feed him prota--- and breastmilk alternatively,
there was no improvement of the body weight. Now the staff give him only
prota-- and the body weight gain is good.  Aother baby is a case of
intenstinal obstruction post operation. She is still breastfed now. But
progressive cholestasis is also noted. Now the staff is considering to shift
the feeding to prota---.
I'd suggested the staff to use the hindmilk. But she asked that in hind milk
there was lots of fat,esp. polyunsaturated long chain fatty acid, would it
be difficult to be digested by the baby. I could not find the answer.
Any suggestion and reference will be highly appreciated. Thanks in advance.
Chao-Huei Chen M.D<[log in to unmask]>
Department of Pediatrics,Taichung Veterans General Hospital
160, sec 3, Chung Kang Rd,Taichung 407,Taiwan