yes this baby can have EBM even though he has an ileosotomy.
Yes ,he may not initially absorb his feeds as well and a certain amount of
fluid will can through the ileostomy.The baby will probable be given
transparental nutrition and lipids through a central line to compensate for
what he loose through his ostomy.

The baby will eventually have an ostoimy bag over his stomas(opening from
intestine onto abdominal wall).There is nothing to say that he will have the
ostomy for ages.It is only to rest the bowel and give it time to heal before
they rejoin the two ends of bowel together.

The amount of bowel that has been removed effects when they will do
re-astomastis of the ostomy.They may have to wait for the bowel to grow abit
before it is long enough to be stitched together.
If mum is able to supply EBM we perfer to give that first,usually we grade
them up to full feeds once the surgeons/neos say we can start feeds this is
often within the first 10days post surgery.

By watching the amopung of fluid in the ostomy bag once ostomy is working we
can guage  by this and the babies weight how the gut is absorbing feeds.If
not tolerating breast milk may have to have sometype of predigested
alimentary formula such as Pepti-Jnr etc once this is tolerated and baby has
good weight gains  then the gradual change over to EBM is started.It is a
wait and see time with these babys.

I have just looked after 24wk twins ,one required an ileostomy very early on
due to a perforation of gut.Was ventilator and then NCPAP took a long time
to come off this.Had TPN /Lipids for alot longer then normal along with EBM
and also some Pepti-Jnr when absorbtion/weight gasin was not good but
eventually went onto to full EBM feeds.

It was round the 2-3month mark before baby had ostomy closed.

Is she supplying breast milk for the other twin,if so this will get milk
supply going until they tell her the ostomy one can have EBM .

http://www.neonatology.org/syllabus/nec.html This will take you to What NEC
is,how it is treated and the complications that occur from it with regard
feedings.

Anne Clements RN EM BNS
Brisabne QLD
Australia

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