Here's what I've got so far. This is being posted per mom's request.
material in <<>> is directly from mom.
<<My milk has been consistently low in triglycerides & glycerol
according to analysis by the Mayo Clinic Lab. My 6-month old baby has
had weight problems since he was 1 week old. This was complicated by an
undiagnosed or treated tongue- tie, and a chronic untreated nipple
lesion. I insisted on frenectomy & a nipple biopsy at 10 weeks. I
thought this would put us on the right course.
I rented a pump to increase my supply. I took fenugreek and flax seed
oil capsules to boost my milk supply & quality after the biopsy & a bout
of mastitis. These treatments doubled my supply & triglycerides, but
the level is still below normal. Flax seed oil gives me & my baby gas.
I also get loose stools. I was on 2 1000 mg caps three times a day.
I've switched to eating walnuts rather than taking flax seed oil caps,
but the gas & loose stools continue. I bought some flax seed & can
grind it, but haven't taken the time to do so lately. Baby's head
circumference and height are between 10-25% on the charts; he's doing
well developmentally & is happy & alert. His weight is making steady
upward progress, but he's still not on the chart.
I began feeding the baby real bananas & rice (either ground brown rice
or Cream of Rice) at 5.5 months. He's doing fine, but the pediatrician
wants to see greater rate of gain.[in subsequent email, mom said ped
wants 1 oz per day of gain] He's gaining 3.5 oz/week; he was 11 # 7 oz
at 5.5 mos. I take him on Monday for his 6-month check-up. He was 8 #
at birth, then dropped to 6 # 12 oz at 2 weeks of age; he had lost 15.6%
of his body weight due to tongue-tie, poor latch, and poor breastfeeding
management. I went to a hospital-based IBCLC & to a general
practitioner, but they didn't think he had enough tongue-tie to cause a
problem. They also attributed the chronice nipple dermatitis to
breastfeeding. Unfortunately, it had been present before the baby was
born. The LLL leader was the only one that agreed with me & thought the
frenulum needed snipped. I had to take supportive articles to the
surgeon before he'd do the surgery.
The general practitioner referred me to a pediatrician, who prescribed 4
tsp. MCT oil by mouth daily as a fat supplement. I rarely get more than
2 tsp. in him a day. She'd prefer I give formula to put weight on
quicker, but I don't want casein hydrolysate or soy estrogens in his
diet.
Do you know of anything else I could do to improve my milk quality or
his rate of gain? Do I need to worry about his lack of high gain? He's
in the normal range for his age.>>
This is very significant to me:
<< Baby's head circumference and height are between 10-25% on the
charts; he's doing well developmentally & is happy & alert. His weight
is making steady upward progress, but he's still not on the chart.>>
Those figures indicate to me, that this baby is doing well.....needs
watching, but seems to be on the right path finally.
Then on Monday's visit:
<<AARGH...just returned from the pediatrician; she wants to hospitalize
my son to run tests. He gained only 5 oz in the past 2 weeks. He is
11# 12 oz... 2 days before he's 6 months old. He gained 7 oz the
previous 2 weeks. This is the most bf friendly doctor I could find in
this area. She's young & bf her 2 children. I found out today that I
was supposed to be giving 1 oz MCT oil twice a day...I'd been trying to
get in 2 tsp bid. She wants to see him gain 1 oz daily. I mentioned
his gain was within the normal 3-5 oz weekly for this age group. He's
gained over a pound the past month. She's comparing him to a preemie &
expects him to catch up quickly. She thinks he should be proportionate
in height, weight & head circumference. She set up an appointment for
me to see a nutritionist this week. This is not a pediatric
nutritionist...there are none here.
I've been mixing the baby's rice & bananas with rice milk. I know
breast milk would be ideal, but...I'd rather just nurse him frequently &
not fiddle with pumping. I pumped up to 2 oz on one side, and just 10 -
25 ml on the biopsied side back in June & July. The ped. mentioned
hospitalization at that time, but I talked her out of it. As an
alternative I kept a detailed input/output record. She ran several
blood tests & a urinalysis at that time. Everything came back normal,
except low protein. She expectred this due to low triglycerides.
>>
Mom doesn't feel continued concern is warranted, let alone
hospitalization. Close watching? Yes, but she truly feels that they're
back on course and that baby is gaining well. This is number five, the
other four were breastfed as well. She's afraid that if she refuses
hospitalization, that the ped will call DHS/CPS/DFACS since some of
mom's choices (no vaccines, homebirth) are far outside the accepted norm
in her rural southern state.
Ped would like to see baby's weight/height/head circumference all
proportional. i think that's ricidulous. Just as adults come in
tall/thin, short/fat, small heads/large heads, so do babies. My own are
10th weight (and dropping), 25th head, 75Th height and practically vice
versa at 90th head, 50th weight, 25th height.
Absolutely there was cause for concern at the beginning....seems
thought, that this situation is being resolved with close watching.
One of our own lactnet medical professionals...a well known MD who has
written a book on breastfeeding:) did have some contact with mom and it
was at his recommendation that solids be started (she followed the
rec). He didn't recommend the MCT oil.
What is a reasonable gain for this baby at this point? Should he be
expected to be 'catching up' and gaining 1 oz per day? That's what the
ped wants to see.
katherine in atl
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