Anh,
From your case presentation it sounds a distinct possibility would be food
allergies. It sounds like baby does not have problems with bf, so may not be
GERD. Sounds more like history reveals food allergy risks: sibling hx of
milk allergy, atopic disease, does not really like solids. I would think you
need to see a good bf freindly allergist so you can maybe go on an
elimination diet so that your breastmilk can be free of whatever offending
allergen(s) are affecting baby, if in fact this is the culprit. And it does
seem the most likely diagnosis from what you have presented. I do not
believe in the breast/pacifier cause. I think taking away the breastmilk
would not help the wt gain. I think breast compression to increase intake
and fat, and post feed pumping to give more fat to baby. I agree with high
calorie solids. Make whatever is offered and accepted really "count" towards
the calorie count. I do not think decreasing bf and adding pediasure seems
logical.

Is the baby now meeting devel. milestones? If not, could be some kind of
devel. delay, often difficult to diagnose. Perhaps a devel. specialist pedi.
could be seen. Would the eye problems affect baby's sitting up etc?
If stool tests were normal, all other metab. studies, and thyroid then that
pretty much rules out the celiac, CF, hyperthyroid issues.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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