OK, maybe it is just me, BUT, it seems like I find the most obscure and
difficult questions and manage to stump the whole profession.  So, here
goes--briefly, I work as an RN,IBCLC at a free standing pediatric
hospital.  We are a regional center and receive complex children from an
eight state region.  On rare occasion we have seen infants with swallow
disorders that cause them to aspirate fluids into their lungs when they
take fluids by mouth.  In the past, we just thickened the fluids with
rice cereal and the babies did OK.  Recently a baby with this problem was
in our level 3 nursery.  Our Swallow Team (they take the infants to
radiology and thin or thicken barium to watch the swallow under
fluoroscopy) dietitian began noticing difficulty getting breastmilk to
stay thick.  She did a small experiment with frozen human milk using both
rice cereal and Thick-it (a corn based product) and found that within 5
minutes that the human milk returned to a thin state (amylase action?).
She did allow the milk to thaw and warm to room temp..  The only human
milk that would stay thick was milk she heated to bubbling first and then
added cereal to.  This swallowing problem seems to be fairly uncommon
but, the medical response is to then feed the infant artificial baby milk
that will stay thick :-( !!  These infants are often facing many other
medical problems and aspiration pneumonia is not an OK thing.  Has anyone
out there in Lactnet Land dealt with this issue?  Did you find a
substance that worked?  I plan to do some investigating myself but would
rather not reinvent the wheel if possible.  So put on your thinking caps
and see what we can come up with.  I have a supply of frozen milk to use
and a friend or two who can get me some of the fresh stuff.  One idea was
to try fruit pectin?  We really do try to support our breastfeeding moms
100%,  it feels awful to feed an infant the other stuff when we have the
gold standard stuff available.  I know us level 3 units often have
greater struggle when supporting breastfeeding so any help will be
GREATLY appreciated. Thank you so very much in advance, I will share any
new results I get with anyone interested.

Lorry Watkins,RN,IBCLC
Denver, Colorado, on a bright sunny day, wishing the dirty dish fairy
would attack my kitchen and clean it !!!!!
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