Hello Lactneters...
Sorry for the long post, but I am desperate for help with this one. I do
have mom's permission to post and have read every Archived post regarding
bloody stools for the past 5 years (several long sleepless nights).
My name is Leah Kaiser and I am a brand new IBCLC from Murrieta,
California. The patient is actually my sister-in-law, who lives in Camp
Lejeune, North Carolina. She is a 26yo G1P1 who delivered via SVD at 40+6
weeks, no complications during pregnancy or delivery. Baby has been
exclusively breastfed since 30 minutes after delivery.
Here is the situation...At 4 weeks of life, baby started having bright-red
bloody stools. Haven't actually seen the diapers myself since she is
across the country, but she states that blood seems to be clotted inside
the stool as well as coating it. Mom took baby to ER where rectal exam,
baseline CBC and x-rays were normal. Baby's pediatrician suggested mom
eliminate dairy from her diet and f/u in a few weeks. Mom eliminated all
obvious dairy for about 2 weeks w/ no improvement. (I know that is not the
appropriate way or length of time...but I wasn't involved yet). F/U appt
w/ peds showed normal CBC after about 3 weeks of bleeding. Baby was happy
(hardly ever fussy), growing and thriving. Peds suggested appt w/ Ped GI
specialist at a nearby university medical center. She could not get an
appt there for 4 months, so the pediatrician called and spoke w/ one of
the specialists there regarding the case. The specialist diagnosed baby w/
colitis over the phone and stated that he was "allergic to mom's milk"
(don't we love that phrase). He suggested starting Neutramagen and having
her pump for 6-8 weeks until he "grew out of it."
This is where I got involved....after several nights of reading Lactnet
Archives, one email to Dr Jack Newman, and several other telephone
consultations, we decided that she would cont. to breastfeed as long as
baby's CBC stayed WNL and he continued to grow/thrive. Mom also started a
strict elimination diet...(she has only eaten Bananas, Rice, Applesause,
white toast, and boiled chicken (unseasoned) for 10 days, at which point
the bleeding seemed to have stopped. 2 days ago, mom treated herself to
one sweet potato w/ brown sugar (NO butter though) and the next day the
bleeding resumed. She describes it as being fairly heavy again. Baby is
now 9 weeks old.
As for the possibility of over-abundant supply (foremilk vs. hindmilk),
mom is feeding one side per every 2-3 feeds and pumps the other side.
Also noted from the Archives...some possible correlation b/w bloody stools
and multi-vitamin drops in newborns. Baby was prescribed multi-vitamin w/
iron since birth. She stopped administering these about three weeks ago
after I found out he was taking them and told her to STOP!!!!
She called tonight frustrated that the bleeding had started again and
wondering if she should just give him the Neutramagen. She is losing a lot
of weight and quite frankly sick of eating bananas, rice and applesauce
three meals per day. She is willing to continue doing so if it is the best
thing to do. She knows that her pediatrician will give her a hard time if
she continues to seek care for the bleeding (since he recommended
switching to formula long ago). She does have an appt w/ the "university
hospital" (I won't say which one...but if any of you are from NC and want
to talk about this offline, please email me) in mid-January. Right now, I
have her pumping and feeding him EBM via a bottle (trying to mix the
foremilk and hindmilk to see if that helps). I told her to continue the
bland diet that seemed to help (no sweet potatoes) until I get back to
her. I am running out of ideas.
Any suggestions I have missed would be most helpful. Also, if any of you
are in the North Carolina area and can recommend an LC, pediatrician, or
specialist for her to see, please contanct me offline. Her husband is
currently deployed until March of next year, so she could use all of the
support she can get. Thank you in advance for your wise counsel!
Respectfully,
Leah D. Kaiser, RN, BSN, IBCLC, RLC
Murrieta, California
Mom to 19 month old Nicole and 11 week old Joshua (who is fortnuately
nursing like a pro)
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
