Greeting lactnetters from rainy Louisville,Ky. where a yearly craze called
Derby Fever is in full swing. ( We have this big horse race this weekend
called
The Kentucky Derby);hot air balloon races, steamboat races, mini-marathons,
parades
all occur this week.
But alas I must work &  not play too much.

ON a serious note--- Help--
I'm an LC in a local hospital doing about 55-60% initial starting
breastfeeding.I'm consulting with a mom whose baby has reflux.  I saw thenm
first a month ago when the baby wasn't back to birth wt at 4wks: bw--8-3,
2wks--7-6,  4wks--7-8.
Assessed latch on & suck; corrected problem & instructed mom to nurse longer
on first side to get to hindmilk &/or pump first to remove foremilk & get to
hindmilk sooner. SNS used to get more  in baby & to help strengthen suck.

5weeks---7-10.   Ped admitted baby to hospital for work up--sweat test(r/o
cystic fibrosis -- neg results), blood & urine tests, T4, & UGI.  T4 off but
said not unusual at this age(????).  UGI showed reflux.  Baby had been
spitting up right after feeds; some liquid, some curdled--on ebm only.
Ped ordered thickened  supplements after breastfeeding. Mom started this but
found baby started to reject breast for bottles( 3rd baby to breastfeed & a
real advocate). she then was only giving 1-3 thickened feedings daily of 1-2oz
after  breastfeeding.
MOnday baby was up to 8lb 6oz.  lab work done--CBC & T4.    CBC showed a drop
in hemoglobin(iron levels) from 12 to 6.  Retested next day & results the
same. Sent to Pediatric gastrointerologist for evaluation.  She wants to scope
baby on Friday to look for bleeding.
She also wants mom to stop breastfeeding  because baby not absorbing
breastmilk ei:poor weight gain. ( she didn't seem to hear mom say that they
had just had a 9oz gain in 1 week) She wants  mom to feed baby ABM alimentum.
Said he'd absorb it better.  Sounds like she doesn't know breastmilk easiest
to absorb & less caustic with the reflux.
Does anyone have info on reflux & low hgb, bleeding etc????
I've discussed cows milk allergies & reflux but restressed problems with dairy
products.
Mom told GI that she wouldn't stop breastfeeding(  Good for her).  Her concern
is does she need to give ABM  to baby with breastfeeding???  Anyone out there
lurking that  has dealt with this???
All help will be greatly appreciated.

Thanks,
Debbie  Moses RN, IBCLC in KY