Hello! This is my first time posting to Lactnet, and I apologize in advance
if I do this incorrectly. My teenaged son calls me "electronically
challenged". He's right. I have been a Labor and Delivery/Newborn Nursery
nurse for 21 years, and last year received my IBCLC. I am currently working
20 hours/week as the staff LC, and 12 hours in the department as a RN. I
have been able to learn very valuable information, and appreciate been able
to listen in on Lactnet.
I could use your advice, I will try to make this concise. My Mom has given
me premission to post this and is also hoping for some help. This is her
first baby, and she has changed careers to fulltime Mom.
Baby is a 5 month old, Birth wt 7#13oz, no problems with delivery, no
epidural. He is exclusively BF. At 2 weeks of age, Mom was put on
Amoxicillin for an infected episiotomy. Within 24 hours, baby began what
Mom describes at "constant straining/pushing" like he needed to stool. He
would wake up crying, straining, would go on for "hours". BMs were
brown-rusty. She stopped the antibiotic after 5 days, thinking it was the
cause of baby's discomfort. Within 48 hours, baby improved, but this has
never gone away. He would continue off and on for up to 5 hours before
falling asleep. At that time Mom stopped eating dairy, eggs, nuts, citrus,
red meat, without any improvement.
At 8 weeks, baby had frank red blood ( about a tablespoon), from his rectum.
Dr. said it was a common rectal fissure. Streaks of red blood continued for
the next 2 weeks, and Mom strongly requested a referral at10 weeks of age.
The pediatric gasteroenterologist stated: impossible to be a rectal fissure,
and it was either 1: prolasped rectum, or 2: protein allergy to Mom's milk.
Evaluation showed all labwork within normal limits except platelets were
"very high". Was told to come back in 2 weeks. In two weeks, Dr. did a
rectal biopsy and diagnosed "colitis secondary to protein intolerence to
breastmilk". Dr. felt it was mild enough to keep on BF and ordered the med
Rowasa 1/4 teaspoon orally three times a day. No improvement in symptoms
next three weeks. His bottom gets excoriated with blisters, especially when
Mom took those antibiotics, and when he started them for an ear infection
(his symptoms immediately worsened with stools like spinach). At 5 months
he is 17 pounds, appears healthy, and is very happy when this stuff isn't
going on. Mom changed peds, and current one is very supportive of
breastfeeding, but both doctors have told mom she needs to wean and go to
special formula with predigested protein to heal baby's gut, otherwise, live
with the problem, and basically, don't keep coming back. He currently has
bilateral ear infections, but they did not put him on antibiotics, fearful
of the consequences.
Do any of you have ideas, advice, help you can give this poor Mom and babe?
We would really appreciate anything.
Thank you!!
Catherine Pridie, RN BSN IBCLC
in Prescott, Arizona, USA (in the mountains NW of Phoenix)
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