Actually this is generally fixable and mom needs to see the ped surgeon
ahead of time, meet him/her, get reassured. Plan to deliver in or near
hospital where baby will have surgery. I imagine it will be c-sec. She
needs to know why her so digestible milk is just the thing to help prevent
infections, constipation. She needs some time to figure this all out
(surgery for herself, then baby, possible separation, pumping after a
c-section). Knowing this all ahead of time will be so much better than -
surprise! your baby has this problem :-( Hope you can help her deal with
all of this. Sincerely, Pat in SNJ
----- Original Message -----
From: "Nancy Holtzman" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, October 05, 2004 9:01 PM
Subject: Re: baby with abdominal birth defect
Dee -
I immediately thought of the extremely high risk of NEC this little one may
encounter. Anything the mother can due to lower the potential for NEC or
sepsis could save this baby's life. I wonder if the mom's (apparent)
reluctance to BF/provide milk has anything to do with fear of getting
attached to a baby who will be critically ill...?
Supporting Refs: (dozens!) here:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A
bstract&list_uids=15296589> &db=pubmed&dopt=Abstract&list_uids=15296589
Here's a nice one, can't get much more current or explicit than this:
Adv Neonatal Care. 2003 Jun;3(3):107-20.
Current controversies in the understanding of necrotizing enterocolitis.
Part 1. Noerr B.
Neonatal Intensive Care Unit, Penn State Milton S. Hershey Medical Center,
Mail Code H108, 500 University Dr, PO Box 850, Hershey, PA 17033, USA.
[log in to unmask]
Necrotizing enterocolitis (NEC) has widespread implications for neonates.
While mostly affecting preterm neonates, full-term neonates, especially
those with congenital heart disease, are also at risk. Although the exact
pathogenesis of NEC remains elusive, three major factors, a pathogenic
organism, enteral feedings, and bowel compromise, coalesce in at-risk
neonates to produce bowel injury. Initiation of the inflammatory cascade
likely serves as a common pathway for the disorder. Clinical signs and
symptoms range from mild feeding intolerance with abdominal distension to
catastrophic disease with bowel perforation, peritonitis, and cardiovascular
collapse. Vigilant assessment of at-risk neonates is crucial. When
conservative medical management fails to halt injury, surgical intervention
is often needed. Strategies to decrease the incidence and ultimately prevent
NEC loom on the horizon, such as exclusive use of human breastmilk for
enteral feedings and administration of probiotics.
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