Telephone call from a mom today - (friend of a friend)
Son is 5 mo old. Birthweight of 6lbs, 8oz.  Currently at 10 lbs.
Born with Tetralogy of Fallot, was in NICU for 1 mo - she pumped and breastfed
baby after discharge.  At 3 mo (weighed 8 lbs) baby had Bronchiolitis was
hospitalized, while there developed impacted intestines and had a colostomy.
Mom was told she needed to give baby vegetables and formula (Nutramagen plus a
protein fortifier) to increase weight gain and thicken the consistency of the
bowel movement due to colostomy.  Baby was getting cereal mixed with
Nurtramagen, vegetables, baby desserts, and still mom was able to maintain
breastfeeding.  However, she was recently given a "Muscle relaxant" injection
(she was unable to give me the name - I asked her to find out) and told not to
breastfeed for 24 hours.  Baby then refused to nurse.  Mom is very upset as she
wants to keep on breastfeeding.  Recent weight gain - 8 oz in 2 weeks.

Questions:

Is it necessary to give the baby all these other foods to keep bowel movement
harder for the colostomy?

Can we use breastmilk fortifier in an SNS to increase calories and reduce and
subsequently eliminate  the  bottles?

I suggested she give all supplementary food with a spoon or cup feeding,
eliminate pacifier, and offer breast frequently until breastfeeding established
again.   She should pump prior to offering the breast so the hindmilk is
consumed completely, and use her milk to mix with cereal or any other foods she
plans to give the baby.  He sleeps 6 hrs per night after a cereal bottle,
suggested night feed when she gets baby up for medications.

Will be seeing mom on Monday, would appreciate other ideas - this is my first
Colostomy baby.  In fact, we're bartering services.  Mom will teach me how to
handle a colostomy in exchange for our visit.  (Family very poor.)

Jeanette Panchula BSW, RN, IBCLC