(I'm not an MD, but I am a mom of a baby who may develop this once he is no longer exclusively taking human milk. Also, I'm an information junkie, so I've learned a little bit about the disease now rather than later.) Here is an article gives a good description of the physiology, diagnosis, and treatment of this disease: http://www.healthatoz.com/healthatoz/Atoz/ency/ renal_tubular_acidosis.jsp 2 key issues: First: "Type 4 renal tubular acidosis is NOT (emphasis mine) hereditary, but is associated with diabetes mellitus, sickle cell anemia, an autoimmune disease, or an obstructed urinary tract." So, it needs to be assessed WHY he has Type 4 RTA. Likely, you already know what the issue(s) is (are). The cause of the RTA help you have an understanding of the impact on weight gain. ---and---- Second: "Treatment: In type 4 RTA acidity will normalize if potassium is reduced. This is done by changing the diet and by using diuretic medicines that promote potassium excretion in the urine." So, human milk is the best low-potassium food he could be on. Renal babies have trouble with nursing in that they generally lack the energy it takes to get the amount of milk they need directly from the breast. As I mentioned above, my nephrologist mentioned that it is possible my baby will develop Type 4 RTA once he is no longer taking in breastmilk. It can happen when they start eating solids, introduce formula, or wean altogether. I have a lot more information, and I would be glad to share it with you privately without taking up the LactNet airwaves... Katie Bredbeck mama to 2 boys and lactivist [log in to unmask] On Tuesday, November 23, 2004, at 09:17 AM, Kathy Parkes wrote: > I am currently working with an infant diagnosed with Type 4 > Renal-tubular > acidosis, who is having a tremendous problem gaining weight with > exclusive > breastfeeding. We are working on the lactation issues. But I am > wondering about > the physiology of this disease and how it impacts weight gain in an > infant. Can > any of our wonderful docs on Lactnet enlighten me? > > Kathy Parkes, RN, IBCLC, RLC > The Lactation Connection (TLC), Inc. > San Antonio, TX *********************************************** 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