Dear Maria Parlapiano

RE gavage infusion of EMM - from Breastfeeding and Human Lactation, Jan
Riordan and Kathleen Auerbach, page 259.  "First, whenever possible, infants
should be fed EMM by intermittent bolus infusion.  The rate of administration
should be sufficiently slow to minimize or prevent adverse consequences of
rapid gastric filling.  Second, for those infants who must receive CNG
(continuous) infusion of EMM, selected safeguards are required.  These
include:  routine bacteriologic surveillance of EMM....................
#2 infusing the EMM at the higheset possible rate deemed safe for the infant,
in order to minimize bacterial growth and nutrient loss.  #3  use of a
syringe pump placed at a 45 degree angle and small lumen infusion tubing to
minimize nutrient loss.  #4.  daily measurement of the lipid content of EMM
by creamatocrit (Lucas et al., 1978; Lemons, Schreiner & Gresham, 1980 ) at
the distal end of the infusion system, in order to estimate the caloric value
of EMM that is actually received by the infant.  #5 Changing syringe and
tubing every four hours to minimize bacterial growth.

Maria, I've always tried to figure out the 45 degree angle and how it
decreases the amount of fat that would adhere to the insides of the tube?
 You talked of using a short tube and that makes sense to me.

Kathy Bodden