I work in an Australian NICU where we often look after omphalocele and
gastroschesis babies.these days surgeons attempt to replace their guts the
same day they are born,in the unit and not theatre.Although ,there are some
incidence when so much is outside that it is difficult to just push it back
and they have to go to theatre ,if the abdominal space is not big enough for
the gut etc to fit back in then they may have to put it in a special type of
bag and  string it up so that it goes back into the abdominal space by
gravity.This may take some time before they can close over the external
abdominal wall.

These babies generally are feed not with IV fluids but transparental
nutrition and lipids,these are their electrolytes,amino acids,minerals ,fats
etc not as good as breast milk and yes they certainly don't gain weight as
well.

Once the gut is considered able to tolerate EBM then it will be tried. It
can be sometime before they progress from NG/OG tube feeds to breast feeds.

We've had mums who have expressed for ages before their babies had their
finally surgery and went to the breast.

 she  can probably reduce her expressing down to 6 times a day,as long as
she keeps her supply going and increase  the number once baby is on full EBM
feeds to build up her supply again.

Surely the hospital should be able to store some of her milk, can she store
some at home and perhaps donate some if there is too much to store.The
hospital should be encouraging her to keep expressing and finding ways to
ensure storage of her EBM until baby is able to tolerate it.These type of
babies benefit from having EBM in the long run.

If you can find someone who has been through the same situation that she can
talk to would be extremely helpful to her.


Hope this is of some help

Anne Clements RN EM BNS
Brisbane QLD
Australia

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