Thank you all for your insightful replies (and the righteous indignation
made me feel a little better, too.)

After talking with our hospital dietician and looking at the actual contents
of various nurtitional formulas, this mom has decided to continue to feed
breastmilk as much as baby will tolerate, plus solids which we are working
on fortifying to increase calories and nutrients.  Our dietician was able to
come up with some good recipes and ideas for increasing nutrient dense foods.

We're also increasing his treatment for reflux, thinking if he doesn't hurt
and throw up so much, he may eat better.

Is anyone aware of any resources or references for the use of human milk as
a large part of the diet of an older infant or child?  It is generally
understood that human milk is not sufficient as the complete diet of a 1
year old infant, but do we know this for sure?  And what nutrients are
important to get in with complementary foods for the human milk fed infant?

I really pondered the idea that perhaps I'm not a good health care provider
for this family since we are friends, but I think we're doing fine in our
therapeutic relationship.  The fact that I like these people I hope doesn't
mean I can't care for them adequately.

I've been mystified by the responses this family has evoked from the medical
field.  Their son was born after a homebirth transfer, and they really have
never participated in allopathic medicine before this happened to their son.
There seems to be an attitude among a lot of the specialists that they have
dealt with that these parents need to be made to feel bad for their choices.
 Also, there seems to be a strong desire to make these parents "face
reality" so that anything the parents mention as a positive in their son's
life is immediately shot down by a specialist "He isn't really looking at
you"  "He's not holding his head better, he just has increased tone" and
that kind of thing.  The mom reports that just about every visit makes her
feel so bad, and yet caring for her son doesn't make her feel bad.  They do
have a lot of hope for the future, which may not turn out to have a basis in
reality, but why is it so important to "face reality?"  Reality will happen
slowly, day by day, and so far these parents have admirably coped with
everything thrown at them.

Our IBCLC at WIC, who loans this mom her pump was equally horrified that the
mom was told she had "outlived her usefulness" to her son.  The LC's
response was that these specialists seem to want to take every bit of
normalcy away from this mom.  Providing her milk for her son has been one of
the few things she's been able to do for him, and to tell her it is useless
is just so hurtful.  This mom struggled with supply with her first child
after a very rocky start, and supplemented the whole length of her nursing
relationship which ended in a nursing strike at 8 mos.  To be able to
provide milk for her son all this time has been very healing for this mom,
when so much else has gone wrong.

Thanks for your help, and for listening to me vent!

Jennifer Tieman
Family Physician
Mom to 4, including my nursling Caroline Rose (29 mos)

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