Dear friends,

We have an interesting case in our hands.  Mother gave birth to a baby
approximately 25 weeks gestation.  Emergency C-section due to placenta
abruption, mom's kidneys shutting down, high blood pressure, etc.  You name
what could go wrong......it did.  This mother is lucky to be alive!  She was
just recently taken off of dialysis, three weeks after delivering her baby.

Anyway, baby was sent downtown to Rush-Presbyterian, where they have the
micro-premies.  Dr. Paula Meier works at that hospital.  Our NICU moms are
on the same system as Rush-Presbyterian as far as pumpinhg and storing milk.

Unbelievably, this mom pumped and brough in a nice milk supply.  She started
bringing lots of milk in for her baby.  Baby is now stable and back in our
NICU, doing pretty well.  Mom has now been ree-admitted and has  been tested
for Factor 5, and is positive.  Her internist started her on Coumadin.  She
has been told she will be on Coumadin for the rest of her life.

Here's where breastfeeding is in question:  The neonatologist has informed
the mother that he does not want the milk used from when she began on the
Coumadin.  He wants her to pump and dump until two and a half days after
she's been off of the Coumadin.  We provided the neonatologist with info
from Tom Hale's book.  The neonatologist is afraid of intracranial bleeding
if the Coumadin tainted milk is used.

Baby is also being tested and may be at risk for Factor 5.

We told mom to take the milk home and freeze it to use for later use instead
of pumping and dumping.
The question is:  Is there any remote  risk in using this milk for this
premie.? Baby is now 29 weeks gestational age.   ......and yes I know that
you can't assess the baby based on my limited information.

We have decided that this is something we can all learn from as LCs.

Has anyone else encountered this or a similiar situation?

Wondering what  your thoughts are.

Connie Chiavario, IBCLC

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