The easiest way to do this is to allow the milk to thaw in it's original  
container undisturbed, so the fat rises to the top.  Then take a clean 5F  
feeding tube (attached to an appropriate-size syringe) and pass it carefully  
through the fat layer - disturbing it as little as possible - and siphon out the  
"skim" milk from the bottom of the container - leaving a little "skim milk"  
below the fat layer as you siphon down.  You waste a little milk, but the  fat 
concentration is minimal.  This has worked well for me for the last 2  
chylothorax patients.  Remember to have your dietitian calculate how much  MCT Oil 
needs to be added to the EBM.  If more calories or protein are  needed, you can 
add Portagen to the mix.
 
 
Nancy
Nancy E. Wight MD, IBCLC, FABM,  FAAP
Neonatologist
Sharp Mary Birch Hospital for Women and Rady Children's  Hospital San Diego
Medical Director, Sharp HealthCare Lactation  Services
San Diego, CA 
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