Chylous pleural effusion is the extravasation of lymph fluid into the pleural space. This occurs as a result of obstruction of or surgical trauma to the pulmonary lymphatic system. One of the important therapies for this condition is to decrease lymphatic flow by limiting enteral fat intake. The use of mother's milk has been avoided because of its fat content. Formulas with no fat or enriched with medium chain triglycerides have been encouraged. This study reports the successful use of fat free mother's milk in three infants who had a chylous pleural effusion. After obtaining consent from the mother and the medical team, the mother's milk was centrifuged in the cold for 15 minutes. After centrifugation, the milk separated into a solidified fat top layer and a lower liquid portion. The fat free liquid portion was then poured into collection cups and frozen for the patient's use at a later date. The mean fat removed was 5 ± 1 g/dL (mean ± SD). Total recovery of the milk was 95 ± 2%. For 1000 mL of milk, the processing time took about 45 minutes. The use of fat free mother's milk was successful in three infants with no reaccumulation of the chylous pleural effusion. The infants were later transitioned to their own mother's milk over 2 to 4 weeks. In summary, the processing of fat free mother's milk is simple and may be an important dietary therapy for infants with chylous effusion.
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