Jay,
We hava preemie in the NICU who has been on TPN(total perenteral nutrition) due
to "early NEC"(Necrotizing Enterocolitis).  The MD has been trying for two weeks
to get him on EBM.  He seems to tolerate it for 24 hours, then begins with
"residuals" then they stop the feeds.  He's up to 3 lbs, but not getting
stronger this way.  Yesterday one of the nurses diluted the EBM saying "maybe
it's too rich."  The MD, willing to try anything, just stood by - no residuals
this time.  As the TPN is feeding the baby at this time, she was more interested
in getting the gut going than in the number of calories and the balance at this
time.  They also used a glycerine supporitory to get some stool and see if that
would help with the peristaltic motion.  I'd like to hear from experienced NICU
people on what suggestions to give.  Mom is great - away from home (US), she
comes twice daily to see him and has over 80 oz of EBM in the freezer!  (Dad
says they have no room for "grown-up" food.)  I wanted to try some "kangaroo"
care - baby between mom's breasts, upright, getting skin to skin, and feeding in
that position to see how things went, but was told they had worked for 2 hours
getting the line (IV) into him and they don't want him moved that much.
Your suggestions will be greatly appreciated.
Jeanette Panchula, BSW,LLLL, IBCLC,RN
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