Neil Campbell, MD (Australia) did a wonderful plenary session for the 1993 ILCA conference on breastmilk feeding of seriously ill babies. His overriding comment: It's not the nature of the problem but the motivation of those involved that determines whether or not a baby can be breastfed. Among the slides he shows are a couple of babies with externalized bowel, although the term "omphalocele" isn't used. He talks about how the bowel may be utterly unable to function at first, and may then have severe malabsorption problems. Since lactose is considered to be one of the big problems, it used to be that "sophisticated artificial milks" were considered necessary. Later, it was generally agreed that breastmilk could be *tried* as a first feed, but *when* diarrhea occurred, the baby would need to be switched to the sophisticated artificial feed. In his facility, however, they would make numerous attempts with human milk before abandoning it. At a time when 50% of Australian babies overall were discharged breastfeeding, *50% of the babies in his facility who were born with major bowel abnormalities went home breastfeeding*. He did stress, however, that about a third went home still unable to tolerate human milk. I wonder: if lactose is the chief problem, why not just add lactase to the milk, and offer these babies lactose-free breastmilk?? Seems simple enough, and well worth a go if the straight stuff isn't working. He has pictures of a baby with a massive jaw tumor... breastfeeding; with a grossly enlarged tongue... breastfeeding; in a rigid legs-in-the-air frame that's drawing his pelvis into line... breastfeeding. Those of you who have his video, dig it out and view it again. It's *very* satisfying, and his overriding message is worth repeating: it isn't the nature of the problem but the motivation of those involved that determines whether or not a baby can be breastfed. Diane Wiessinger, MS, IBCLC Ithaca, NY www.wiessinger.baka.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html