Thank you so much for all the replies.
The concern was that peanuts could trigger a G6PD crisis in this baby who apparently has extremely low levels of the enzyme. The mom was warned never to eat any nuts (not just fava beans).
In the end the mom pumped and dumped for 24 hours and the baby is back to breastfeeding.
Dr Rahmat Bibi Bagus (MBChB)
GP, IBCLC, La Leche League Leader
PR 0258490
IBCLC L 303328
18 Phillips St
Parow Valley
Cape Town
7500
Bookings on What’sApp at 079 639 2542
(Operatings hours Mornings Monday to Saturday 9am-12pm
Evenings 6.30pm-8pm
All appointments strictly by appointment)
-----Original Message-----
From: Lactation Information and Discussion <[log in to unmask]> On Behalf Of Tricia Shamblin
Sent: Friday, July 12, 2024 1:07 PM
To: [log in to unmask]
Subject: G6PD and the breastfed baby
I may have missed the original message, but I have taken care of a few of these babies over the years and they were all in crises at time of birth. It is apparently a common time for that to happen, also when they are sick. The thing that was universal about them was a rapidly elevating level of jaundice when they were not coombs positive or had other risk factors and were breastfeeding well initially. And the jaundice did not respond to phototherapy or increased breastfeeding or supplementation with breast milk or donor milk. Typically by the time they are under phototherapy, breastfeeding becomes poor because they are becoming sleepier at the breast, too. At least that has been my experience. It's more common on males and those of African descent. If we are seeing worsening jaundice even when the baby is taking in 30 to 40 mL of breast milk and under phototherapy, they will typically test for this. All of the babies were put on formula for a day or two and responded immediately, sometimes within 24 hours. That is another sign it is probably G6PD. Once they were out of crises they all resumed breastfeeding with no issues. It's just something with the way these babies process breast milk during a crises where they are not able to recover from it very well. The parents were advised that when the baby gets sick in the future, to watch for signs of jaundice and contact their baby's healthcare provider if they see any. All the babies I've seen were then able to resume breastfeeding without any difficulty. If a baby isn't in crises or jaundice was improving well with breastfeeding, I would see no need to supplement with formula. It is only used in cases where all other treatments are not working. Tricia Shamblin, RN, IBCLC
Date: Wed, 10 Jul 2024 22:22:46 -0700
From: Felicia Henry <[log in to unmask]>
Subject: Re: G6PD in breastfed baby
I'm not sure what the concern is. My son has this issue and it's mainly fava beans and the medication he is on for his UC (he doesn't process it effectively and it can build up in his system). The only issue would be if the child also has a peanut allergy. While my son is also allergic to peanuts (like his father is) not sure why eating peanuts would mean to limit breastfeeding.
Felicia Henry
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Date: Thu, 11 Jul 2024 09:32:21 +0200
From: Doctor Bagus <[log in to unmask]>
Subject: Re: G6PD in breastfed baby
Thank you for responding Felicia, this was my gut feeling too, that the physician is being overly cautious and unnecessarily interrupting breastfeeding.
I was reaching out to find out if anyone had ever experienced such a situation that a baby with G6PD develops a crisis as a reaction to peanut exposure.
Warm regards
Dr Rahmat Bibi Bagus (MBChB)
GP, IBCLC, La Leche League Leader
PR 0258490
IBCLC L 303328
18 Phillips St
Parow Valley
Cape Town
7500
Bookings on What’sApp at 079 639 2542
(Operatings hours Mornings Monday to Saturday 9am-12pm Evenings 6.30pm-8pm All appointments strictly by appointment)
-----Original Message-----
From: Lactation Information and Discussion <[log in to unmask]> On Behalf Of Felicia Henry
Sent: Thursday, July 11, 2024 7:23 AM
To: [log in to unmask]
Subject: Re: G6PD in breastfed baby
I'm not sure what the concern is. My son has this issue and it's mainly fava beans and the medication he is on for his UC (he doesn't process it effectively and it can build up in his system). The only issue would be if the child also has a peanut allergy. While my son is also allergic to peanuts (like his father is) not sure why eating peanuts would mean to limit breastfeeding.
Felicia Henry
*************************************************************
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