I agree with the thoughts on NEC for this baby (which could be up to 10
times more likely to develop if artificial milk is used), but there are
many other things to consider.  First, we know that this baby will be
having surgery, and this will increase his metabolic rate.  Increasing the
risk of poor absorption of nutrients from a bowel that has been
manipulated.  Increasing the already high risk of infection.  The
colostrum and milk will coat the intestinal wall to provide IgA, lysozyme,
lactoferrin, and other protective components. Encourage mom to touch baby
to triger not only a beginning of grieving the loss of her perfect baby,
but also bonding with her less than perfect baby.  This touch may also
trigger the production of antibodies in mom's milk to specific bugs in the
baby's NICU environment through the enteromammary pathway.

The colostrum and milk will also increase the motitlity of the bowel,
decreasing the risk of ilius (basically plugging)due to constipation,
which is great when the bowel is manipulated with abdominal surgery.
The bifidus factor results in gram-positive beneficial interstional flora,
rather than gram-negative pathogenic bacteria found in the gut. This
increased motlity will also help drop the potential of increased bilirubin
when the bowels don't move.

The milk will also help with fluid balance, especially if the bowel is
left out of the body for any length of time.  This must be done sometimes
when the skin of the abdomen is too small to contain all of the bowel
present.

Also the post op recovery will be quickened by the easily digested lower
casein/whey ratio as well as concentrated protein (in the form of amino
acids) in the colostrum that build body tissue.  Once the baby can
directly breastfeed, the baby conserves oxygen while feeding, compared to
bottlefeeding.

I do hope that the mom will consider providing human milk, even if she has
no plans to direct breastfeed.  A second alternative would be to get donor
milk

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