---------- Forwarded message ----------
Date: Mon, 6 Jan 1997 03:07:29 -0600 (CST)
From: "Maryelle G. Vonlanthen" <[log in to unmask]>
To: lactnet <[log in to unmask]>
Subject: biliary hypoplasia..



---------- Forwarded message ----------
Date: Mon, 6 Jan 1997 03:04:38 -0600 (CST)
From: "Maryelle G. Vonlanthen" <[log in to unmask]>
To: lactnet <[log in to unmask]>



To Janette panchula
Sorry to take so long but have not looked at my E mail for a while.
About Biliary hypoplasia:  it results in decreased bile excretion into the
gut and therefore maldigestion.  Many of these babies will have
nutritional problems and grow poorly.  I agree with Jack that BF should
not be interrupted.  I am assuming that you mean Alimentum and not
Augmentin(antibiotic) for substituting to BF.
Here is what a pediatric gi who knows about BF would recommend:

1.  Continue to BF and watch growth very carfully
2.  Follow fat soluble vit levels (A,E, D and K) and supplement with ADEK
1 cc per day initially and therapeutic doses of these vits if levels
decrease.
3.  If baby grows fine: not problem. Continue to BF as if nothing
happenend.

4. Chances are at some point the baby may have problems with growth (they
almos all do no matter how fed).  If so I would start supplement either
with SNS but may not work well because many babies with liver disease are
anorexic so I usually teach parents to use nightime drip feedings.  I use
something like pregestimil because it is 50% of fat as MCT (the others are
not to my knowledge).One could also use expressed breastmilk if available.
Titrate supplements to baby's needs.

5.  Portagen is 90% MCT and is not recommended for liver disease.

Hope this info clarifies some points.  let me know if questions

Maryelle (pedi GI)