PTP
Working with a mom and 9mo baby, had numerous problems nursing initially, have now had TT/ULT released, nursing at least once during the night,  (sleeping 7pm to 4 am, nurse , wake at 6:30 and nurse again - was sleeping 12 hrs without nursing when we first met) refuses solids on the most part. Was not gaining since 6 months when told to nurse every 3 hrs only and were advised, at the same time, to sleep train. began gaining after TT release @ 7 1/2 mo and increased feedings, are seeing nutritionist and working on increasing iron levels, more zinc rich foods, were on cyproheptadine for one month and after initial good weight gain, per GI dr stopped cold turkey. Baby became ill with a "cold" within 2 days with vomiting of much phlegm, lost weight again and refused all solids. Has had a gain of 10 oz in the past 17 days but GI dr wants baby to take appetitie stimulant again. When asked why her baby would have no appetite, his reply was that he sees "a lot of breastfed babies with no appetite."

Has anyone else heard of this phenomenon? 

My experience is that many nursing babies nurse a lot in the second half of the year when allowed to self determine how much to eat and most will eventually decide how much of what to eat and grow quite normally.  

Other questions I have are: do we have any research that links high cortisol levels to poor appetite in infants (re sleep training)?
Those Physicians here who have ever had a baby on cyproheptadine, have you noticed quitting this med cold turkey have a rebound effect and have you had better outcomes with weaning off gradually? Is there any other, more holistic of an appetite stimulant a baby can take, that parents can look into? 

Baby, who I saw again today, has good skin tone, moist mucous membranes, alert, interactive, fed well at the Breast, has  frequent and normal wet and  daily BM diapers. Mother is offering the breast frequently throughout the day (every 1 - 1 1/2 hrs) and reports that he will sometimes nurse well and sometimes says no. I did point out that if he is not nursing for many hours at night, and eating minimum solid foods (a taste here and there) then he needs to be nursing frequently and yes, that might be every 1 - 1 1/2 hrs to keep weight gain up. 

Any suggestions, links to further info will be helpful. The forums I have perused re cyproheptadine showed a rebound effect in some adults who have taken it re: allergy symptoms as well as some reporting a loss of appetite once stopping. 

When I hear the terrible things this mother had been told by HCPs - I want to scream. No wonder breastfeeding rates plummet by 3 months. 

Celina Dykstra, IBCLC in NH where the snow never ends..... 

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