I don't know if  I spelled it right, but I am now working with a NICU baby
who was born about a month ago at 36 weeks with total gastrocscesis- where
the intestines develop outside of the baby's abdominal cavity. The baby had
corrective surgery before 24 hours old, and when 12-14 days post op was tried
on feeds- the neo tried breast milk twice, and both times the baby had
bilious green vomiting, so baby was started on pregestomil. (Which in my
humble opinion smells and looks almost as bad going in as it does coming
out). Any way, baby is on continuous gavage feeds, is today up to full
feedings (18cc/hour), so TPN can be D/C'd. Neonatalogist is planning to try
breastmilk again, but has warned mom that baby's gut may not be adequately
mature or stable enough for it. Mom previously breastfed two older children,
is pumping marginally ( 3-5x/) just to keep up a small supply because her
freezer is so full of unused milk, is discouraged but happy her baby is well.
My question from any or all who may know: Are baby's with gastrocscesis
truely unable to digest or absorb breastmilk because of their impaired gut?
Needless to say, this baby has never been on the breast, or a bottle for that
matter, but loves his pacifier. I have worked with many babies with this
condition and they are frequently poor feeders not because they cannot suck
but because they cannot swallow and their gut is so messed up they just
refuse to eat, or if they get it down they have frequent emesis. It's like
their gut knows it is messed up and doesn't want the baby to eat, even though
the baby is hungry. These babies frequently go home on pregestamil, they
cannot digest anything else, and they frequently need g- tubes. So can they
tolerate breastmilk?

Anyone know? I know Dr. Jack is in Sacramento now,  but I have faith in the
depth and bredth of knowledge of Lactnetters.

Debbie Rabin, OTR, CLC
Los Angeles, CA