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Subject:
From:
"Trish Whitehouse, RN, LLLLeader" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 31 Jul 2003 20:52:37 -0400
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Hi Rachel,

My name is Trish Whitehouse and we had a baby back in 2000 who developed a
chylothorax after heart surgery.  My husband devised a very efficient way
to skim the milk using a centrifuge.  It is posted on our web site, which
is:

http://home.earthlink.net/~chester2001

There are several sections on our web site that will be of interest to
you.  First, if you click on "Index of documents", there you will
see "Leaven article, April/May 2003"  That is a story I wrote that tells
about the whole ordeal and how we came to know that skimming milk was even
possible.  Then under documents are lab results of the skim milk (and
comparisons with whole milk and milk that was left to stand 24 and 48
hours and separated naturally.)  There are step by step directions
explaining how to centrifuge the milk, speed (RPMs) of the centrifuge,
length of time you have to centrifuge it, and several pictures of how to
best "pour out" the skim and cream so they don't mix.  Using this process
yielded 0.02% fat in the milk, which was confirmed more than once by dairy
lab analysis.

Save the butterfat (the rest of the skim after it had been separated).  We
mistakenly dumped ours down the drain and after the chylothorax had healed
and my son could have full fat milk again, I had to do the process
backwards to get the butterfat to add to the whole milk so he would gain
weight.  He was volume sensitive, and that butterfat is worth a whopping
425 cal/100cc.

On an interesting note, and to put out to all your collective minds who
work with critically ill babies and know anything about chylothoraxes, I
am presently in contact with a mom whose baby is in the NICU after heart
surgery.  The baby has a chylothorax, which is the only one that is as
severe as Bobby's.  Sounds like he is draining 600 or more cc of lymphatic
fluid/day. He just started the skim milk yesterday, and over night his
drainage increased.  She said he is also septic, and I asked when the
sepsis was diagnosed, and she said two days ago.

I don't know a lot of the intricate physiology of sepsis, but I know
watching Bobby through his septic bouts that his whole body would blow up,
and leak intercellular fluid into the extracellular spaces (is that how it
goes, it's been a long time since I was in Nsg. school.) and he'd take on
the appearance of a stuffed sausage.  I am wondering if the increase of
lymphatic drainage was coincidental...more associated with the sepsis,
rather than the use of the skimmed breastmilk.  This is the first time I
have heard of it "not working", and actually making the drainage worse.
We have worked with about 15 moms and hospitals across the country during
these last 2+ years and the skim milk has always been a better alternative
to the Portagen for babies with chylothoraces.

The mom is understandably too afraid to try it again, as the baby was put
back on the vent and is very unstable again.

Any questions you  have, Rachel, I would be glad to answer them or get you
in touch with MDs and IBCLCs who have worked with us or have learned how
to do it long distance.  I understand my article is not a "credible"
source, even though it is from a LLL publication; sometimes MDs want to
only speak to other MDs or see research articles.  I know people you can
speak to if you need to.

Trish Whitehouse, RN, LLL Leader

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