Just to clarify:

Hirschsprung's disease actually occurs when a portion of the myenteric
nerve plexus either fails to form or regresses during fetal development,
so that part of the rectum and often colon is tonically contracted, and
cannot relax to allow stool to pass through.  The babies have the
appearance of being partially or completely obstructed and the healthy
colon above that area dilates to compensate.  The gold standard of
diagnosis is a rectal biopsy, which will show absence of the nerves.
Hopefully, this has been done or is in the works.

There are many options available for surgery, including a multi-stage
procedure where the baby is given a colostomy, the colon is allowed to
rest and the baby to grow, and a completion pull-through procedure is done
later.  Commonly now, this will be done as a one-step procedure, and can
be done laparoscopically and even "incision-less" where the surgery is
essentially done transrectally.  I had the pleasure of doing research
under Dr. Jacob Langer while he was at St. Louis Children's Hospital (he's
now Chief of Pediatric Surgery at Hospital for Sick Children in Toronto.)
Our initial Hirschsprung's study got entangled in red tape, but I did a
lot of background research.  He is an excellent resource for HD info.

Importantly, HD is linked with a number of congenital abnormalities like
Down's Syndrome.  Though this should probably have been obvious, keep
those things in mind when thinking about breastfeeding difficulties.

Shannon McElearney, MD
Research Fellow, PGY4, Dept. of General Surgery
University of Virginia
who once upon a time wanted to be a pediatric surgeon until she had her
own lovely 16-month old nursling and realized as much as she loved it, she
couldn't handle the long hours away from him for the rest of her life...

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