In a message dated 10/06/2003 10:02:16 AM Eastern Daylight Time,
[log in to unmask] writes:

From my experience in working at a children's hospital, the "cookie" test was
a Video Swallow Study. It looks at what happens to the milk as it is
swallowed. The problem with mixing EBM with cereal is that the milk breaks down the
starch in the cereal almost immediately so it will not stay thick. In our
hospital, if we need to thicken EBM, we use a product called Simply Thick ( no
financial interest). It is made of xantham gum and comes in 2
consistencies....honey and nectar.
Regarding the pumping, I have found that moms in my NICU who do not have
infants going to breast usually cannot maintain a supply using a Pump In Style.
Same with Whisperwear. These pumps were not made to maintain a milk supply when
infant is not going to breast. Her best bet is a hospital grade pump.
The reference for 4 hours hang time for EBM can be found in HMBANA Guidelines
for Hospitalized or Sick Infant.  I would be cautious with the 10 hours with
fresh milk. We are not talking about a normal, healthy infant at this point
and I would error on the side of conservatism. Also, when feeding EBM via a
pump, be sure to feed from a syringe with tip pointed up and the shortest amount
of tubing possible. Research shows that the longer the tubing, the more fat is
lost in delivery because of it adhering to the sides of the tubing. Same with
hanging the milk in a feeding bag as opposed to a syringe. If you want any of
these references, please email me privately and I can provide them to you.
Chris Smith, RN, IBCLC
Columbus Children's Hospital

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