I would appreciate ideas for this case. 6 week old child, born at 7-5, now
weighs 11.5 pounds. Baby's dad is a physician. Baby has been spitting up
frequently since birth. Parents would not be concerned so much about this,
because baby is obviously growing well, but baby seems to be in pain during
feeding and cries a lot. No choking episodes, just frequent pain and
vomiting. We have removed dairy from mom's diet, (for two weeks, still
dairy free) and mom only feeds one breast each feed. Parents tried reflux
meds which did not seem to make a difference, I believe propulsid and
reglan. They were trying to just go with this and have weekly weight checks.
Baby gained only one ounce last week, so they got very concerned. I told
them wait and see, could have been a fluke since it was on a different scale
in ped's other office, but they didn't want to wait and see.
Went to see pediatric gastroenterologist last week who diagnosed breastmilk
allergy.
Told them to take baby off breast for 72 hours, pump milk and feed
predigested. Parents decided to try. Baby refused to drink from bottle,
refused predigested. They were only able to get small amounts in her (5
ounces in 24 hours). They went back to gastroenterologist. He said baby had
blood in stool. Dad looked at test, could not see a positive reaction. No
obvious blood. Dr. scoped the baby. Said, sorry it is not breastmilk
allergy, it is gastritis from reflux. Severe redness in throat and
esophagus.
This MD says he diagnoses 10-11 cases of breastmilk allergy every month.
What suggestions would you have for this mom? She has tried holding the
baby upright after feeds. She has tried smaller frequent feeds. Do you
think this baby would be helped by some chiropractic adjustments? More
medication? More dietary changes for mom? All suggestions would be
appreciated.
Ann Calandro,RNC,IBCLC
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