rob, i have a client whose baby had the exact same sx as the one you desribe,
and was started on only a very few solids due to the prejudices of the
pediatrician, diagnosed "happy to starve" at one year because after a few
months of iron being put in every food he ate besides breastmilk, he refused
all foods due to the taste. then the ped said she "had to wean because he is
not eating solids because of snacking on breastmilk" (one of my most least
favorite wrong ideas, since it implies some sort of psychological sickness
associated with wanting to breastfeed). i had the mom do some of the same
things you mentioned, compression, increasing nursing, etc. at the same time
she quit using the extra iron for a month.
that seemed to help, actually, the baby began to eat food better. but i urged
her to get more diagnostic work done, because the causes for the anemia were
not clear (not that they would be, but still). jack suggested testing for
lead poisoning, which is far more common than most people think. along the
way she went to the pediatric gastroenterologist and insisted on a more
thorough workup, and lo and behold the baby has a narrowed pylorus, making it
difficult for food to pass through. apparently not enough of a problem to
have been caught as pyloric stenosis early, but enough to cause part of the
problem.
so it turns out that at least part of the "problem" was that this smart baby
knew he couldn't get much food to travel through him, so he stuck with the
one food that worked best . . . his mother's milk.
so don't overlook other problems that might co-exist with the anemia, and do
advise the mother to do lacto-engineering, supplementing with the skimmed fat
if he won't eat the cereal. i also found that the mother in this case was
eating a low fat diet. i know, i know adding fat to the mother's diet won't
necessarily increase fat in the milk. but i suggested she try to get her
levels up to at least what is described as ideal in lawrence.
carol brussel IBCLC
<A HREF="http://www.breastfeedinghelp.com/">Breastfeedinghelp</A>
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