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There's a good article in The Journal of Pediatric Surgery 1998
May;33(5):705-7
by Jayanthi S, Seymour P, Puntis JW and Stringer MD titled "Necrotizing
enterocolitis after gastroschisis repair: a preventable complication?
In a nutshell: exclusive breastmilk group had (0 of 12) no NEC
[necrotizing enterocolitis] Formula & breastmilk 1(of 19) case NEC (5%)
and exclusive formula group had 7of 23 (30%) NEC
The baby may be in a special kind of set up called a "silo" which is a
special kind of bandage to cover and protect the intestines that is
suspended from above the baby so as to provide adequate circulation through
those intestines that are still outside the body. It looks a lot like an
upside-down ice cream cone - consider the baby the scoop of ice cream going
into the cone belly first. It makes going to the breast unrealistic
while the silo is in place unless you've got really long pendulous breasts
and you're a contortionist to boot.[there's just not a lot of space on
these warmers]
I recommend that mom pump right from the beginning, and indicate that she
only wants the baby to have her milk based on the NEC/breastmilk studies
in the literature - and pump, pump, pump - because these requests are too
easily "blown off" by medical personnel when they only see scant amounts
of milk and theyv'e got a whole closet full of formula by comparison. If
she gets a creative nicu nurse, maybe they can figure out how to get the
breast to the baby - since the baby can't get to the breast.
Let us know what happens!
Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications
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