Dear Lactnetters,
I'd like to get your thoughts on the following case, with the mom's permission. The baby has now seen at least 4 different lactation consultants and a few LLL leaders, not to mention an OT/CST, besides the pediatrician. Over the past 71/2 wks. he has gone from not latching at all to at least latching well on the right breast. Still having fits with the left. Mom is most concerned about blood in the stool. Here's the summary:
7 1/2 wk old infant, gaining weight, well hydrated, normal amount of wet and poopy diapers, appetite is fine, no fever.
a.. cries beginning halfway through feeding and continues after feeding until you can calm him down like a Reflux baby would
b.. cries when having gas or bowel movement
c.. bowels are now dark green, streaked with blood and mucous
d.. nasal congestion
e.. Doctor ran tests on stool for inflammation due to bacteria or allergies--came back negative
f.. Doc then consulted a Ped. G.I. who feels that it's an allergy to something in breastmilk and would like to try Neocate predigested formula before doing more invasive tests such as endoscopic procedures
g.. OT/CST saw him last week for "colicky" symptoms and latch difficulty. Couldn't even get her finger in his mouth because he was so fussy. Did some other work to loosen his left side. He had not been turning his head to his left, but now he can. He has a very small, tight, clampy latch.
h.. Mom has eliminated soy, dairy, and peanuts for at least 2/12 weeks (added back in Parmesan cheese without making a difference.) Starting yesterday, the ped asked her to eat only fruits, veggies, chicken, and fish. No grains. No nuts or olive oil.
i.. She had gestational diabetes and was very faithful to the diet, which involved huge amounts of protein. Since mom is mostly vegetarian, that mean a lot of nuts and peanut butter, with fish. Very limited fruits and carbs.
j.. Labor was long, with epidural and pitocin. Mom thinks she may have had antibiotics due to water being broken for a long time.
Mom really doesn't necessarily want to introduce formula, but feels she would if that would "fix" the problem somehow. She is very worried about the more invasive procedures because the baby is already to miserable, and has spent so much time being poked and prodded since birth.
Her question is what is causing the baby to need something other than breastmilk to begin with, and would formula really be the answer in the long run? Will it help pinpoint what it is in her milk (if anything) that the baby is allergic to? Mom plans to pump even if she uses formula, and the ped said she could reintroduce it slowly after 3-7 days.
Have you ever heard of a similar situation, and do you have any additional insights? I have checked the archives already.
Thanks so much!
Kathryn Ward, IBCLC
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