Andrea,
Thanks so much for updating us on the baby who now has been diagnosed with
Cystic Fibrosis.
You know how we say "think of horses, not zebras?" This means, of course, to
first think of the common reasons why a baby is not gaining, and then go on
to the uncommon ones. Especially in a 5#10 ounce baby, I would first look at
the effectiveness of feeds, milk supply of mother, and I would assess the
milk transfer at breast. Once I had determined that baby was indeed taking
in adequate volume/calories, but not gaining, then I would refer for medical
evaluation. I would not wonder if mother's milk was too thin or too weak
(some still think this). So, I think you handled this appropriately. You
will likely see ALOT MORE cases of low milk supply, or ineffective milk
removal, than you will of malabsorption syndromes.
This is the logical and appropriate way to approach this, unless, of course,
the baby presented as a sick baby.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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