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Subject:
From:
Katharine West <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 1 Jan 1997 23:54:39 -0800
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Jennifer, as unusual as it may sound, I think it makes absolutely
excellent sense. For a brief year, I worked as a research nurse in peds
GI at a major bench-research childrens hospital, and learned more than I
ever will need about the function of the gut. I have also worked in peds
hospice so have fair working knowledge of chemo side effects. Let me
share why I think this is a great idea.

Chemotherapy is designed to destroy rapid-growing cells (such as cancer)
but it will also destroy any healthy, rapidly growing cells in the body.
The cells lining the small intestines, AKA the "brush border", are among
the hardest hit. The brush border replaces itself approximately every 3
days if I remember my anatomy. The brush border is significant for
nutrient absorption. Lose the brush border and one develops poor
nutrition because the gut cannot absorb proteins and fats specifically
(the molecules are too large to cross into the circulation without the
aid of the brush border cells), but does fair with simple carbohydrates
(some of which can pass without the aid of those cells), and does fine
with water and clear liquids (which cross over via a completely
different mechanism and do not need the brush border cells). (This is
why, after a gastroenteritis illness with vomiting and/or diarrhea, the
recommendation is clear liquids, followed by simple carbs as in the
bananas, white rice, applesauce, tea and plain white toast diet.)

So your question is actually "Is EBM absorbable across a damaged brush
border?" and the answer is probably a resounding "yes!" because of the
smaller size of the BM nutrient molecules, the large percentage of water
content (BM is 80% water, the quantity of which helps "push" the
molecules across), and other similar reasons. Colostrum would crossover
even more readily. Milk provides complete nutrition, which is why many
oncology diets are dairy-based on products such as Ensure (product
endorsement *not* implied but used for illustration). Also, liquid diets
and frequent small quantities during chemo are more easily tolerated and
may even decrease nausea. The EBM can be left plain or flavored and
frozen into "momsicles", turned into cottage cheese or yogurt (the
acidophilus and bifid cultures would be very therapeutic for the
chemo-affected gut), custard (the cooked egg would be bonus nutrition),
or used as a base for scones for the whole family (EBM, being sweeter
than cow's milk, makes great scones, BTW). Since the father would be
drinking his wife's milk, and presumably knows her "infection/contagion
status" one needn't worry about pasteurization, and could drink it "as
is" or "fresh." (If they kiss and share such body fluids, EBM can't be
any more problematic.) The anti-infective properties would be extremely
important as chemo also adversely affects the immune system for the
duration (another set of rapid-growth cells).

He's a fortunate man. If they decide to proceed with this (and I think
they should), please encourage them to keep track of such things as
weight gain/loss, chemo side effects, baseline nutrition (labwork),
infections, etc and then *publish it* as a case study of one. Maybe his
oncologist would be interested in doing so - oncologists are pretty
flexible doctors as a rule, when presented with logical alternative
support therapies. Good luck and blessings for the family.

Katharine West, BSN, MPH, FNP in-training
Sherman Oaks, CA

"Sometimes I've believed as many as six impossible things before
breakfast!" Lewis Carroll

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