When I first became an LC I had the most puzzling case of FTT.  Mom would
come into the office full of milk and the baby would nurse eagerly.  Yet the
weight gain was not there, barely and ounce or two a week.  I could not see a
reason for the FTT nor did the pediatric staff.  She claimed she was
supplementing with the formula I had given her after every feeding and
reported the proper number and type of stools and wet diapers.
   Then several weeks into follow up care I noticed she was limping as she
came into my office.  She told me she fell and the one hour ride on the bus to
see me had made her a little stiff.  But when she opened her blouse to nurse
the baby I cried.  She was bruised everywhere that could not be seen outside
of her clothes.  We sat and cried together as she told me the whole story
   Apparently the father of the baby started beating her in pregnancy, hoping
that the baby would not survive.  During her pregnancy and beyond he was
taking her food stamps to buy beer and drugs.  Mom had been living on popcorn
and water for months.  She could only feed the baby when he wasn't home or he
was asleep.  The night before he had caught her nursing the baby and beat her
severely.
   Fortunately, I enough of the right resources and connections to get her
into a battered woman's shelter that day.  I was told that she was sent out of
state for her protection, the father was arrested and would be charged.  As
far as I know the shelter made it so she could "disappear off the face of the
earth." I never saw her again.
  What I am trying to point out here is sometimes there is far more to the
picture that what we see in the office.  What manifests as a feeding problem
is not always related to the feeding itself.  With this mom, NOTHING looked
wrong on the surface.  I can't imagine what her milk quality was like given
what she was eating.  There was always a copious supply in the office most
likely because she wasn't feeding the baby at home.
   Perhaps her maternal instincts drove her to see me that day (even with the
fresh bruises) on the outside hope that I might be able to help.  Obviously
she hadn't been ready to tell me the truth before.
   Similar cases with abused women, sexual abuse survivors have taught me,
when you ask about any type of abuse be prepared to handle the answer, no
matter how shocking, disgusting or sad.  (I 've had several that I was the
first person they ever told.) You've opened the flood gates be prepared to
have everything come to a halt while you mop up.
Some think I have a negative outlook on life because I have been accused of
seeing drugs and abuse issues too quickly.  When I've been wrong and that is
rare, I am glad but I don't think I'm going to change a thing.
"When you've eliminated the impossible whatever remains, however improbable,
must be the truth." Sherlock Holms (Sir Arthur Conan Doyle)
Marie Davis