I assume that the anemia has been diagnosed as Iron Deficiency anemia and not B-12 deficiency? 
Re:head circumference: is baby diagnosed with microcephalic? And has she been tested for CMV? 
Just some thoughts off the top of my head
Melinda Harris-Moulton
IBCLC, ARNP
Washington State

Sent from my iPad

> On Jul 20, 2014, at 11:04 AM, Pamela Morrison <[log in to unmask]> wrote:
> 
> Dear all
> 
> I'm posting for a colleague who has permission to ask for your collective wisdom about a client she has been working with for over a year.
> 
> Breastfed second baby, now 14 months old.  Has had low weight gain more or less since birth, (born at 2.5 kg, was only 2.8 kg at 6 weeks when she first consulted my colleague. The baby now weighs ~7.5 kg.  Has always had low muscle tone and anaemia, and now assessed as having the mental and physical development of a 6 month old.  Her head circumference is below 0.4th centile.
> 
> The parents have been told there is a genetic copy number deletion but, pending more bloodwork, have not been given specific information.  Mother herself is small but has never suffered from anaemia.
> 
> As well as breastfeeding, baby eats other foods well, taking a wide variety of foods including red meat, chicken, cereals, veg, salads, greens, tomatoes, fruit.   Had iron supplements which make her vomit. Stools are soft but contain large amounts of undigested food.
> 
> Consultant wants mother to stop breastfeeding and replace breastmilk with formula because of iron fortification. Tells mother that anaemia can cause brain development issues and made her feel extremely guilty.   The baby has another prescription for more iron supplements and referral to a developmental specialist.
> 
> Has anyone heard of a syndrome or medical condition which would include these symptoms.  Mother is very committed to breastfeeding and, of course, would like to continue.  She will probably seek another medical opinion, but seeks more info first.
> 
> Thanks if you can help.
> 
> Pamela Morrison IBCLC
> Rustington, England
> 
> 
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