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Subject:
From:
Ingrid Tilstra <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 3 Jun 2009 07:32:55 -0700
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Is the baby getting vitamin D drops?  If so, stop those for a week or so and
see if it helps.

Ingrid

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Westra, Mary
Sent: June 1, 2009 8:24 AM
To: [log in to unmask]
Subject: 7 weeks of diarrhea


I have permission to post from mother of this baby.  Baby is now 15
weeks old.  Vaginal birth, primip at 36 weeks.  Infant supplemented with
ABM and EBM for first several weeks of life. He was treated for one week
for hyperbilirubinemia  with phototherapy. Since then, baby has been fed
exclusively at the breast.  Mother had reported that baby was fussy and
"colicky" often. Block feedings were instituted.  Mother deleted all
dairy from diet at approximately 5 weeks, followed by beef, peanut and
other high allergen products.   At seven weeks of life, baby developed
diarrhea.  Stools were sent for culture, ova and parasites.  All
negative.  Basically, baby has been having watery, mucousy, green stools
for the past seven weeks..  Some days are worse than others. Mother has
been eating rice, chicken and cooked pears only.  Baby has been gaining
weight normally. Hematocrit and hemoglobin are normal. Blood has only
been seen rarely in stool.  Bowel sounds are hyperactive and baby
appears in pain frequently. Baby is being closely monitored by
pediatrician, who has been fairly supportive of continuing the
breastfeeding exclusively. She did give mother the option of trying
elemental formula, and taking baby off breast for a short time.  Mother
does not want to do this.  Mother then took the baby to pediatric GI
specialist (we do not have any breastfeeding friendly GI specialists in
our city) who recommended 2 months of elemental formula.   When asked
what the risks of keeping the baby on breastmilk, the GI specialist told
her that baby could go into anaphylactic shock from the breastmilk.
Yikes.  He claims that he has seen a case of this. So my questions are:

1) Has anyone heard of anaphylactic shock from breastmilk before?

2) What treatment options are recommended by you?

3) I remember a session at ILCA conference about 7 years ago in Florida
discussing this subject.  The presenter was from Canada.  I can not find
my syllabus for that conference, nor can I remember her name or outcomes
of the case presentations she presented. Does this session sound
familiar to anyone, and if so, do you have a contact for the presenter?

4) Mother is concerned about her own nutritional status; she is 10
pounds below prepregnancy weight. She has started taking a natural
prenatal multivitamin, but finds it difficult to get the calories she
needs from her restricted diet.  Do you have any nutrition suggestions
for her?



Thanks so much in advance,



Mary Westra RN, IBCLC




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