Need some feedback or ideas for 2 moms I have been working with:
1)Had a mom call today with c/o very painful letdown sensation for last 2
wks or so.  Baby is 6 wks old. History seems unremarkable.  3rd BF baby for
her.  Does have strong MER and she agrees they are probably related.
Discussed normal MER sensations but she feels this is much worse than that.
 Discussed/ reviewed positioning to be sure she is keeping lower jaw well
into breast and baby squarely on.  States OB r/o yeast by giving her
Diflucan with no change in sensation after completion of course...no sx in
mom or baby BTW.  Suggested she try positions used for overactive letdown
for a few days to see if improved.  Any other ideas?
2)Mom with 18 mo still BF though mom had been considering weaning.Main
concern:  baby weighs 19#.  She is tall/thin in wt for length but is
developmentally advanced in most areas.  Her mom is also extremely thin.
She had diet eval by nutritionist @peds office. Caloric intake Ok for
maintenance but low for growth.  She suggested adding fats to baby diet.
Complicating factor:  has not been able to tolerate milk in moms diet or
her own when tried @ 1yr.  Also lactose and soy intolerant per mom.  She is
asking for suggestions for increasing caloric intake.  Nutritionist
suggested she add vegetable oil to foods(just thought...not soybean oil I
hope).  Someone also suggested adding cornstarch to her diet?  She wants
milk-like beverage but rice milks are low fat or fat free so she doesnt
want to use those.  I wonder if her low wt is just genetic or if she is
anorexic. Mom, that is.
Any flashes of brilliance?  TIA !!!
PS  Baby bwt was about 7#, 16# at 1yr
Peggy Litt, RN, CLC
Hospital-based Lactation Consultant
Quincy, IL
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