Have to run this by my Lactnet resources,
I saw a difficult case for an LC student. Baby born at 37 weeks gestation 5#11
oz.  Afro American G1,P1 23 year old mom.  Pregnancy, Labor and Birth are not
remarkable.  Baby is now 7 weeks old weighs 5#7oz.  Looks horridly emaciated
(like one of those kids you see in save the children programs).  Huge cranial
vault, big eyes, thin face, thin limbs and swollen abdomen.  Wets and stools
are within normal limits.  Taking 2 - 3 ounces of EMM and Formula every 3
hours, average of 20 ounces per 24 hours.
During a recent hospitalization, both baby and mother  had FTT work ups:
genetic, gastric, social and PT/OT consults.  Mom had a full endocrine work
up.  Tests all appear normal.  Neurologist estimated the baby's developmental
age at 37 and 3/7ths weeks three days ago!
Baby has a bizzar suckle--rotary, chomping and chewing, does not draw no
rhythm.  I think the suckle is related to caloric deprivation.  Baby is highly
disorganized.  Is very Hypotonic on the right side including the tongue,
Overactive Perez sign (commonly called the fanny wiggle) on the left.  Same
findings in the mouth.  Muscle tone is definitely better on the left.
The baby screams and fusses CONSTANTLY which is only  burning more calories.
Baby seems to stress at the breast.  The docs want to measure intake so is
primarily bottle fed with a NUK style nipple--does best with the NUK upside
down (hole side toward the tongue).

The condition of this child scares me to death.  My left brain says it is one
of those little known syndromes that no one has found yet.  But I also have a
gut feeling that this is a milk allergy.  I started the baby on Nutramigen
(TM) to supplement what she is able to pump.  Has anyone ever seen  FTT
related to milk based formula?  OR Am I way off base?
Mom is double pumping with a Classic every 3 hours but the stress has her
supply way down.  I had her start Fenugreek capsules and up her intake of
Brewer's Yeast.  Mom started having diarrhea and vomiting almost immediately
after the first dose of Fenugreek.  Apparently diarrhea has been noted in
other mothers from the Fenugreek but no mention of vomiting (See Kathleen
Huggins' article in the latest Rental Roundup from Medela).
Any Ideas?
Marie