Kim,
      I'm just curious--are babies in your NICU fed at all if they are
weaning from the fentanyl that they are on for ECMO once they are
recovering???  Are they fed while on neonatal morphine when withdrawing them
from maternal drug abuse????  Of course they are.  Might be interesting to
find out what his opinions are about these situations, since he doesn't feel
that he needs to back his opinion up with any  research--something that RNs
and LCs are expected to do.  It seems to me that the amount of narcotic that
babies receive directly would be much larger that that received through
breastmilk.   I honestly can't think of any cases of NEC in over 10 years
that was related to  narcotic use...but I can think of multiple reasons why
premies should receive their mothers' milk when it is available.  If premies
got feeding problems from maternal medication use,  I'd tend to think that
breastfed premies would have a higher incidence of NEC, rather than the other
way around.  Many premies are born by C-section, so there's a lot of premies
getting Percocet indirectly postpartum in milk.  It's really hard for a
mother to release milk to a pump if she is uncomfortable, so I'd just as soon
get some milk to feed them with to help PREVENT problems, even if has
teeny-weeny bits of Percocet in it.  Most mothers  don't seem to need
Percocet for more than a couple of days after delivery, if at all.  He should
lighten up.  If you can't make any headway with him, look forward to April,
when there's a new attending coming!!
                                                                      Maureen
Allen RN, BSN, IBCLC

Lactation Consultant-NICU
                                                                      Brigham
and Women's Hospital
                                                                      Boston,
MA

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