I am working with the mom of an ex 28 week premie twin that was discharged
from the hospital at 35 weeks corrected age with his twin. His mom had
started pumping but thru a series of events was unable to provide breastmilk
so both boys went home on formula. They developed an upper respiratory viral
infection 2 weeks after discharge and were readmitted. The other twin
recovered and was  home within 2 weeks. This twin developed NEC, required a
colostomy and a period on  ECMO. He is now starting enteral feeds of formula.
I spoke with this mother regarding the benefits of human milk feeding and she
it trying to relactate. She is home (1 1/2 hours from the hospital) with the
other twin and a 2 year old. She is pumping with a hospital grade pump and
taking Reglan. She is open to the idea of donor milk from a milk bank but
when the NNP mentioned this to the surgeon, he laughed, and said something to
the effect that since they didn't know what virus caused the NEC, he wasn't
taking chances with any infection from donor milk. Fortunately, I was not
present during this conversation because it might have been hard to remain
professional and not confrontational. I would like to educate these people as
to the increased risk regarding short gut and NEC because they are starting
him on formula. Does anyone have any research, protocals that I can show
these physicians to support my position? I emailed Dr. Sharpe in Austin today
and got 2 good articles faxed to me promptly.  I need something that I can
hand to these physicians that they might listen to. Any help would be
appreciated.
Chris Smith, RN, IBCLC

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