To the best of my knowlege, a sweat test is used to identify children
with cystic fibrosis.  I have never heard of a sweat test being used to
identify kidney problems, a urinalysis or IVP would be used to check the
kidneys.

Cystic fibrosis is a major cause of failure to thrive in infants.  If
the child has CF, breastmilk is the very best food, along with
pancreatic enzymes to help her digest proteins and finally grow.

DId anyone do pre/post weights on this baby to differentiate between
true insufficient milk supply and increased metabolic need or other
infant problem?  A baby with CF will take normal amounts of milk and
still not grow, same for kidney or cardiac issues.

Insulin resistence is the root cause of polycystic ovary syndrome.
Insulin resistence in women can lead to androgen excess, which can
interfere with both fertility and milk production (see Lisa Marasco's
work on this topic).  Metformin has been helpful for some women with
insulin resistence in increasing milk supply.  Lisa is a lactnetter,
check the archives for her posts.

Private practice LCs deal with these very complex multi layered cases
quite frequently.  Perhaps you can team up with a private practice IBCLC
from your community to work with this mother, and each of you can teach
each other some new tricks.  When I have a baby with complex medical
needs, I pick the brains of my hospital based RN/IBCLC friends (thanks
Rose).
Catherine Watson Genna, BS, IBCLC  NYC

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