In this paper out of China (https://doi.org/10.1001/jamanetworkopen.2024.7145) Zheng shows the safety and discusses the possible pathophysiologic effect of breast milk used for enemas in preterm infants for meconium evacuation.

Lange et al (https://doi.org/10.1111/apa.16528) and also Gross et al (https://doi.org/10.3390/children9081122) showed that breast milk enemas are used in NICUS in Germany, although in a small amount of cases.

We are using breast milk for enemas for some time now with good experiences. As the evidence is still little, I was wondering if there are some experiences of other centers.

What is your opinion?

Thanks for your question. Breast milk is very precious, we don’t waste it as enema, when we know that once feeding is established meconium will come out anyway and if not there are other ways to do it . Please don’t waste precious milk.

La leche Humana tiene su utilidad en niños humanos como el primer alimento, tanto prematuros como de término y como comentan además de todas sus propiedades excelentes por sí sola es lxante

I know there is an enema study going, Uppsala in Sweden is part of it. And as you know, there is much use in Japan. What liquid used? I think mostly sodium chloride, this is what we use WHEN we do enemas in our unit (which is unusual)

Thank you for your replies!

I agree, that one should never use breast milk for anything else than nutrition as long as there isn’t spare milk available or donor milk demand.

the question is, is it really a “waste” of breast milk in that case, or is the potential benefit for the gut (possible Immunologic effects, possible effects on the microbiom, less irritation of the gut with lower osmalarity, possible propulsive effects, …) a reason to make it a good option.

As we learned from intravenous use in the past, NaCl 0,9% isn’t a really physiologic choice at all.

Agua jabonosa, es mejor y no utilizar leche materna y hay otros medica.entos utilizables.

we use a mixture of glycerine and normal saline in a ratio of 1:1 when required. IT has worked well for us.

We use 5% glucose and glycerine 9:1, 5ml/kgBW

We use Enemas with NS/Glycerine 4:1 ml and we give 10 cc/kgBW under Ultrasound surveillance