Hi Julie and all
You haven't mentioned urine output?? Could this possibly be secondary
lactose intolerance - ie too much milk?? Some of these babies do not gain
weight and some actually lose due to the fast transit through the gut. This
is a fabulous article explaining symptoms and the difference between lactose
intolerance and overload.
http://www.breastfeeding.asn.au/bfinfo/lactose.html
This case reminds me very much of my own first born - over active letdown
and huge over supply (although I didn't know it at the time) - different to
this bub my boy was gaining huge amounts (500 + in some weeks) and I still
thought I didn't have enough mike as he demanded feeds every 1-2 hours day
and night. Frothy green poos. On further investigation he did have a tongue
tie and has also subsequently been diagnosed with coeliac disease (gluten
intolerance). Although these are not necessarily the cause of the lactose
overload.
So out of all that:
1) what is nappy (diaper count)/urine? ?? oversupply
2) what is letdown like - over active letdown?? leading to too much milk
3) if mum is taking vitamin supplements - stop and see if it makes a
difference.
4) gluten or other intolerance is a possibility if dad has this - gut issues
eg crohns, IBD, diverticulitis, coeliac, irritable bowel syndrome, clearly
runs in families.
hope that helps
Del
*~*~*~*~*~*~*~*~*~**~*~*~*~*~*~*~*~*~**~*~*~*~*~*~*~*~*~*
Del Smith
Breastfeeding Counsellor
Australian Breastfeeding Association www.breastfeeding.asn.au
2007 IBCLCE candidate :-))
----- Original Message -----
From: "Julie Conaway" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, July 11, 2007 7:49 AM
Subject: Re: slow weight gain, green stools (long)
Thank you for all your suggestions...
I have not seen any of the things that Cathy mentioned, no respiratory,
cardiac, swallowing issues, no floppiness, no asymmetry. He is an alert
little boy and bright-eyed after a feeding, he does have a 'small' face with
tiny features but I don't think this is abnormal.
I will readily admit, I'm still struggling with recognizing oral
abnormalities. If this baby does have something it is minimal. He does not
have a bubble palate. He has an organized suck and the tongue protrudes
over the bottom gum. I will look again to see if it lifts all the way to
the palate when crying.
But you have really directed me to something I haven't put a lot of thought
into, and that is the basis of all successful breastfeeding, the LATCH!
(Doh! Hitting forehead with heel of hand...) I have been focusing on
supply issues, thinking that mom's supply was suboptimal due to short
infrequent feedings (in baby's first few weeks, due to other obligations),
or possibly age and stress. She also has very small breasts, and therefore
smaller storage capacity. So frequent feedings are important, but they
really shouldn't take an hour.
This baby probably does have latch issues, because mom does have very large
nipples, and as I've mentioned baby has tiny facial features. Probably
means a small mouth too. We've worked to get as much into his mouth as
possible, but his latch is not particularly asymmetric. If he's not
efficiently removing milk, wouldn't this also explain why he's fussy at the
breast? I've always thought he appeared frustrated, like he's hungry but
not getting anything.
Does this sound like a good plan?:
-Work on getting latch more asymmetric and absolutely as much areola as baby
can take.
-Nurse and compress only while baby is actively sucking, them pump
(immediately after feeding? one hour after?)
-Spoon or cup feed EBM to supplement (we really hope to avoid formula since
dad has many food allergies)
-Discuss exclusion diet; I think mom is open to making changes
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