Hail Wise Colleagues,
Have an unusual situation for your input.  Bf toddler, 22 mos old,
diagnosed with (pre-B cell Acute Lymphocytic) Leukemia 3.5 weeks ago.
She is on aggressive chemo since her white count was over 250,000 at
diagnosis.  Protocol includes oral prednisone.  Mom relates that baby bf
20 times a day through the first 9 days of therapy in hosp, asking to
nurse whenever a physician entered the room or an oral medication was
presented.  Discharged home on oral prednisone, which tastes awful.
Baby began vomiting the prednisone, rehospitalized on day 12 to teach
parents how to give it iv.  Day 13 began fever, diarrhea and vomiting,
diagnosed with rotavirus infection, remains hospitalized.  Between the
vomiting induced by the prednisone and the rotavirus, baby began to
associate bf with vomiting, and began to bf less and less, as well as
less effectively, then refuse the breast by day 18.  Nursed a few times
in her sleep between day 19 and day 23, but refused to bf during the day
and refused ehm in a cup (saying "yuk")(discussed sodium elevation, this
was the first milk mom had pumped after days of declining stimulation).
Mom noticed the baby was more likely to bf when on antiemetic drug, has
asked the doctors to keep her on this med for a few days to help break
this cycle.  Last night baby bf during night, and this morning asked to
nurse after touching a painful lesion.  Mom is heartened, but afraid
that the breast and milk refusal will recurr.  The physicians have
suggested sensory alterations in chemo patients as a possible cause.
Mom is well educated and wants to give her baby the extra edge of
continuing to bf during the cancer treatments. Any suggestions beyond
the standard nursing strike recommendations (all of which she has tried
to the best of her ability in a hospital setting) will be appreciated.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]