An omphalocele is may vary in degree of severity,usually the bowel and some
degree of internal organs are exposed (?liver). These babies may be quite
ill depending on the severity of the condition. There may be other related
congenital abnormalities.

Management is to return the bowel and other organs to the abdominal cavity
as soon as possible and close the abdominal wall. This is not necessarily
as simple as it sounds because it depends on the amount of
space/intrabdominal pressure as to how rapidly this can be accomplished
(esp in severe cases.)

Initially the infant will be on intravenous fludis and a naso/oro-gastric
tube for drainage purposes. Internally the bowel needs to be kept "dry" to
aviod distention and infection. Oral feeding is only commenced when healing
has occurred and peristalsis has returned. In some infants this may be a
long process and they may reguire total parental nutrition.

This mother may not be able to breastfeed but the operative word is
initially. There is no doubt in my mind that this child should receive
breastmilk once oral feeding is commenced and should eventually be on the
breast. The mother should be assisted to start pumping and storing straight
after delivery (which may be by C/S)

Kind Regards

Mandy O'Reilly
Nurse Midwife
IBCLC

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