Dear Lactnetters,
I got a message from Judith about this baby and she asked me to send in my
reply to her FYI since she told you that many of you were interested in
what I had to say about this situation.
Hello to all
Great to meet many of you at the LLLI conference in Wa DC!
Maryelle
---------- Forwarded message ----------
Date: Wed, 6 Aug 1997 16:22:41 -0500 (CDT)
From: "Maryelle G. Vonlanthen" <[log in to unmask]>
To: Judith Hain <[log in to unmask]>
Subject: Re: baby in NJ
This time I agree with the pediatric gastroenterologist you consulted.
Baby had a bad start in life with heart disease and major surgery. In
breastfeeding the baby is responsible for the milk production of mom by
appropriate breastfeeding and emptying the breasts. Chances are this
process was disturbed by the surgery and illness of the baby and this
starts a vicious cycle poor weight gain, poor breastfeeding efficiency and
insufficient milk supply for that baby's needs. At this time the needs
are increased because the baby is behind on growth curve. So even if BF
looks good it may not be enough for catch up. In my experience, babies
are able to return to the breast full time after a period of
supplementation because they feel better and are more vigorous and are
better breastfeeders. Night feeds work well. One may be able to
transition fairly soon to sns supplement. I consider the magnitude of
the growth delay such as described in this baby, a nutritional emergency.
As if a car is stuck in a ditch and spinning its wheels. The
supplementation is the recker that will get the baby out of the ditch and
back on track. Because of the stress and decreased stimulation some moms
find it hard to bring up their supply completely but most breastfeed
mostly after this supplementation. Be sure to work as a team with
lactation consultant to maintain supply while supplementing by pumping.
Another issue is the reflux. This baby may have it worse because of
malnutrition. So in my experience a time on continuous drip feeding may
help resolve that situation also. If the baby gains well he can then
handle the reflux better. If not better, he may be needing surgery for it
especially if it causes this many respiratory problems.
Good luck.
Please let me know how things turn out.
Maryelle
On Wed, 6 Aug 1997, Judith Hain wrote:
> Dear Dr. Von Lanten,
> Your name and address were given to me by a number of people on
> Lactnet. I would greatly appreciate any advice you could offer to me
> about my baby, Rhiannon.
>
> My baby's history follows:
>
> Birth 4-1-97 Girl, Good birth, 8 lbs
> 2 days old I noticed baby was blue around lips after nursing
> ultimate diagnosis: Total Anomolous Pulmonary Venous Return
> Surgery at 8 days
> Some feeding, latch-on problems post-op/ NG tube 2-3 days
> Baby down to 6lbs. 7oz
> Discharged at 2wks of age weighing 6lbs. 11oz
> Slow weight gain ever since
> Now at 4 mo- 9lbs 3oz
> Baby nurses every 2-3 hours, good number of wet diapers and bowel
> movements.
> Developmentally age appropiate.
> Post-op baby was diagnosed with Long GT Syndrome, however no EKG since
> can turn this up again. However this condition does preclude many
> different meds.
> Experiences "chest problems"- wheezing, coughing, choking on mucous
> Shows signs of reflux, cries after 10 min. at breast, etc.
> Upper GI shows no other abnormalities, DR assumes reflux
> baby is taking:
> Inderal-every 6 hrs
> Lasix-1x day
> xantac-2x day
> regulan-4x day
> Mother has tried pumping hind milk and using it in SNS- no noticable
> improvement
> Toddler nursing 1-2x day.
> baby is gaining barely 1/2 oz per day at this point. Dr Kurt Brown,
> pediatric gastroenterologist at Childrens' Hospital of PA, wants to see
>
> 1oz
> to 1 1/2 oz per day by August 11th or will begin NG tube (pump at
> night)
> I am concerned about the effect this will have on baby's
> breastfeeding, baby reacts to dairy in my diet.
>
> Thank you in advance for any help you may offer.
> Sincerely,
> Tami Walker
> 609-889-8396
> [log in to unmask]
>
>
>
>
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