> The mom talked again
> to the neonatologist who explained that since Emma had lost the lining
> of her intestine, she would not have the enzymes to break down proteins,
> hence the pre-digested stuff.  Any comments on that one?

What, the neonatologist thinks it'll never come back? I know we have GI
docs lurking here, so please correct me if I'm wrong. But the brush
border of the intenstines is what the neonatologist is referring to, I'm
sure. And, I'm sure this was true during the NEC crisis, as the brush
border is highly vascular; any disruption of the circulation would cause
it to "die" - NEC does this but also to the muscular wall of the gut as
well. I can't recall exactly, but I seem to recall this baby had surgery
which removed the damaged portion of gut. In the meantime, the brush
border has had plenty of time to replace itself. This is the same
problem which chemotherapy causes for cancer treatment - only it is a
chemical etiology rather than vascular, but the result is the same. The
brush border is affected (destroyed) by chemo because it is made of
rapidly growing and replacing cells, and chemo is designed to affect
rapidly growing cells. We replace this lining frequently, normally, week
in and week out as long as we live. Sometimes it takes a beating, as
after intestinal "flu" or food-borne illness. But it regrows quickly!
Thus, I'm certain the baby has long since regrown her lining. One
wonderful thing about breast milk, is that it doesn't require much brush
border function at all to pass into the baby. Nature must have known
breastmilk was food for an immature gut. :-)  Colostrum is even more
protective of the gut...

Katharine West, BSN, MPH
Sherman Oaks, CA