I'm counseling a new mom with a 5 day old infant who was just diagnosed
as having Glutaric Acidemia Type II  (Multiple Acyl-CoA Dehydrogenase
Deficiency).  The literature the dietitian gave me states this is one of the
more common inborn errors of metabolism but it's the first case I've seen and
Lawrence's text does not mention it, nor does Riordan and Auerbach, so I'm
lost.  The neurologist and the dietitian want to feed with a special formula
with Similac with iron RTF as the base.  The Dr. says that's the only way he
can regulate the protein intake.  I provided amino acid content of
 breastmilk but he's not impressed.  The prognosis is not very good for this
baby, no matter what they feed,  so I am looking for references to support
this mom's desire to feed her  breastmilk. Any help would be greatly
appreciated!!
     Also, while I have the courage to send something,  our pediatric surgeon
insists that Nutramigen is easier to digest and thus less traumatic to a
newborn gut than breastmilk and orders all of his surgical pts. be taken off
breastmilk and fed Nutramigen until the parents fuss and complain and the
baby is recovering.  This includes preemies with NEC and subsequent surgery
for same.  I feel Nutramigen has been well marketed and now I must market
breastmilk but I'm in need of  any support and encouragement you may be able
to offer.  References would be helpful too!  Thank you so much for this
wonderful resource!!

Susan Hannum, R.N., I.C.C.E., I.B.C.L.C.
Gulf Breeze, FL