Recently I read discharge notes from a NICU on a baby born a few years back.
Baby was delivered by elective CS for grave IUGR, weighing just 2 lb (900 g)
at nearly 32 weeks.  Compare this with Ellen Shein's case, in which baby
weighed 3.5 lb at the same gest. age.  Baby was in great shape despite the
growth retardation, spent a day or two on CPAP with room air, and rapidly
graduated from IV glucose and p.o. colostrum, to gavage feeds of EBM plus
whatever fortifiers the unit was using at the time.  Mother was able to
bring in an ample supply and was soon providing all the baby's milk.  The
NICU course was remarkable in that the baby developed no complications of
any kind at any time.  Baby was discharged at term fully breastfed (=taking
all feeds at the breast!) and getting vitamin and mineral supplements,
weighed 5# 2 oz., and has continued to do well.  This child is entirely
healthy in every discernible way.  Has not reached school age but is
socially and verbally ahead of age peers, has no attention difficulties, no
visual deficits, no respiratory problems, no eating disturbances, nothing.
Is slim for height, and below 50th percentile for height and weight both.
This is one of those cases you come across far too seldom, but it is
heartwarming when you do.  HMF was used until baby was fully breastfed, then
supplementation was limited to vitamins and minerals.  We can see nothing so
far that would have been improved by continuing HMF longer.

Rachel Myr

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