I posted this a few days ago and got only 1 response, so I am wondering if it is ok if I post it again. Both the pedi and I are looking for suggestions, and ultimately, answers. I will be checking to see if a sweat test for CF has been done. Meanwhile read on if you missed this post before. thanks. The mom is very anxious to continue BF
I hope there will be some answers for my client and me thru the inspired, experienced, and brilliant minds of all you lactnetters.
I will refer to mom as SH, baby is B.
Prenatal hx: Mom gr 4, with 7 & 8 yo girls, breastfed for over 14 months each--no issues with breastfeeding. Boy, T. born 6/18/03, still bf at 13 mo (thru pregnancy, but usually 3-4x/d) and self weaned at 14 mo to "casual" bf status of 1x q 1-2 weeks.
Mom on Zantac and PNVits during preg. Zantac 150mg 1-2x/d thru preg, then 1x/d after birth of B.
B. born 8/27/04 FT 8#7oz, disch 7#13oz. Regained BW by 2 wk, 8#7oz BABY totally BF, no formula ever.
Fussy, jittery, easily disturbed--saw pedi at 3 week, and wt 8#5oz, put on Zantac 0.5ml 3x/d
Mom did not like the idea of meds for 3wk old, so did not give the med for 3 days. B. not better or worse, so decided to give Zantac
At 4 week of age (4 d after starting Zantac) he became jaundiced, eyes appeared sunken, skin tone poor, and had a rash on trunk and head. Rash in ears, scalp as well. Continued to have CNS symptoms of irritability, jitteriness, and exaggerated startle.
Took him in to pedi who found potassium 6, bili 6, SGOT 98, SGPT 70, per pedi also 'slightly hyponatremic' and rec stopping the Zantac (at mom's sug). I
In 5 d he gained 5 oz with potas 0.2, bili 4.1, SGOT 88, SGPT 55
Repeated bl work in 2 days, all normal except liver enzymes now over 100!, no wt gain. Up to now BF, so with consult with specialist at Children's Hospital in BOS, rec stopping BF, and use of Nutramigen.
On nutramigen for 5 days, gained 14 oz and became a "happier baby."
Mom would like nothing more than to go back to bf. Pedi is thinking of putting him on a milk based (and cheaper!) formula in a month or 2, and agrees that it may be possible to put him back on brmilk, if it can be shown that it was not the breastmilk which caused problem. Mom has stopped her Zantac since he was 4 weeks when she began to suspect this as a problem.
I have my own thoughts about this and want to hear what you all think. Please post to me and to Lactnet if possible. Thanks
Michelle Scott, MA, RD, IBCLC, CSP
Lactation Consultant and Pediatric Specialist
Mason, New Hampshire
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