I don't know if I spelled it right, but I am now working with a NICU baby who was born about a month ago at 36 weeks with total gastrocscesis- where the intestines develop outside of the baby's abdominal cavity. The baby had corrective surgery before 24 hours old, and when 12-14 days post op was tried on feeds- the neo tried breast milk twice, and both times the baby had bilious green vomiting, so baby was started on pregestomil. (Which in my humble opinion smells and looks almost as bad going in as it does coming out). Any way, baby is on continuous gavage feeds, is today up to full feedings (18cc/hour), so TPN can be D/C'd. Neonatalogist is planning to try breastmilk again, but has warned mom that baby's gut may not be adequately mature or stable enough for it. Mom previously breastfed two older children, is pumping marginally ( 3-5x/) just to keep up a small supply because her freezer is so full of unused milk, is discouraged but happy her baby is well. My question from any or all who may know: Are baby's with gastrocscesis truely unable to digest or absorb breastmilk because of their impaired gut? Needless to say, this baby has never been on the breast, or a bottle for that matter, but loves his pacifier. I have worked with many babies with this condition and they are frequently poor feeders not because they cannot suck but because they cannot swallow and their gut is so messed up they just refuse to eat, or if they get it down they have frequent emesis. It's like their gut knows it is messed up and doesn't want the baby to eat, even though the baby is hungry. These babies frequently go home on pregestamil, they cannot digest anything else, and they frequently need g- tubes. So can they tolerate breastmilk? Anyone know? I know Dr. Jack is in Sacramento now, but I have faith in the depth and bredth of knowledge of Lactnetters. Debbie Rabin, OTR, CLC Los Angeles, CA