I was asked to consult on a situation where a 1 year old is being fed
breastmilk continuous drip in a kangaroo pump.  After one hour, the milk is
so thick that the nasogastric tube [#8 french] plugs.  The nurses have
tried mixing the bag to prevent separation of the fat. There are no
additives in the milk and no unusual storage issues.  The milk has the
appearance of mashed potatoes after it has been sitting in the bag for
about 1 hour.  The nurses have discovered that keeping a warm pack outside
the bag will keep the milk in liquid form.  I am worried about milk being a
source of infection by keeping it warm. I am having them give the milk by
syringe pump and not warm it.  Suggestions?

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