Helen - I read your story of the IgA deficient 2 year old with growing
amazement.   What a beautiful story, such a success!  And so similar to a
mom/baby I am working with. This one is now 10 months old.  Second baby.
The first baby was breastfed for 8 months.  This one was breastfed for 8
weeks, when mom weaned (I had seen him at 4 weeks, he was quite "difficult",
kept pulling on and off breast, very unhappy, I suspected sensitivity to
cow's milk proteins ingested by mom) but mom made a decision about this on
her own.  Shenow tells me that at 9 weeks he came down with pneumonia,
hospitalised for 2 weeks, very sick indeed, lost a lot of weight, and mom
describes trying to bottle-feed literally sip by sip, managing to get 150 ml
formula into him in a whole day.  He eventually recovered, then went on to
have repeated ear infections, and marginal weight gain.  He was eventually
diagnosed with "low IgA", apparently his IgA level was O.O7, mom said the
test doesn't measure lower than this so this was what was recorded.   She
was told it was "inherited".  I also know *nothing* about this - can anyone
explain?  Anyway, by eight months, when he had had four antibiotics in the
previous five weeks mom was so stressed that the doctor prescribed an
anti-depressant for her and mentioned that it might cause her to lactate,
and if so, she could give try breastfeeding again.  So she came back to me,
six months after weaning.

Manual expression showed she could produce 2 - 3 drops of EBM from each
breast. We went through several strategies she could use to increase this
amount, no guarantees, and discussed how to work towards getting baby back
to the breast.  The latter soon proved not to be an option for her, she
wasn't really keen anyway, but she *really* wanted to work towards providing
EBM, particularly when she heard about the IgA content.  She came back about
10 days later as she was producing about 30 ml each time she expressed.
Last week (just less than two months after she commenced efforts to
re-lactate) she was pumping 310 ml in four pumping sessions each 24 hours.
Now she wants to work towards totally eliminating all formula so is prepared
to pump more often.

The baby is a different child.  Within a week of receiving small amounts of
breastmilk his cheeks turned pink and his skin started to glow.  He had
gained 50g in the previous month, and suddenly now gained 200g in 2 weeks.
At Christmas he had one more ear infection (antibiotic Rx, wont go into
that!), but the duration of this episode was *much* shorter, and he hasn't
had a recurrence since.  He has gained 200g in one week and 300g in another
week.  Mom says he seems to have so much energy he's become quite a handful,
whereas before he was very passive and lethargic.  Mom is *sooo* thrilled
and proud, she can see that all this hard work has made such an amazing
difference to her baby's health.  She tells me she is prepared to provide
EBM for him until he is four years old (this is when consultant paed said
this little guy might "outgrow" this condition).

Like Helen, I would be really interested to know more about IgA deficiency,
can anyone help?

Pamela Morrison IBCLC, (from riot-torn Zimbabwe!)