Thank you all for your speedy replies.  The mom I'm helping is overwhelmed
with gratitude, as am I because I'm learning so much.  Here's some more
information to help (or not):

Mom is adopted so we don't know her genetic history; she is very fair
skinned and has red hair, so maybe of Irish descent?

The blood draw was after fasting five hours, since baby slept through a
nighttime feeding and awoke just before the lab opened (last feeding at
2:50am, drew blood at 8am).

Mom was going to go back for a re-draw today but baby woke up two hours
before the lab opened and she/they couldn't wait to do the blood draw;
she'll try again in the morning.

Mom was tested negative for celiac a few years ago; baby was tested negative
for celiac last month when she started losing weight, but maybe the results
changed?  Mom said baby reacts to oats (vomiting) and wheat (rash and gas)
but not rye and barley.

 Her ped has consulted with the endocrinologist and the cardiologist, and
neither has suggested to her to stop breastfeeding, and the ped supposedly
has only suggested breastfeeding less for cultural reasons.  I agree, she
should have switched peds a long time ago, since she's fought over every
aspect of breastfeeding from the beginning.

The endocrinologist has requested testing the lipase deficiencies because
the urinalysis numbers were off, but she keeps forgetting to put on the
specimen sample bag in the early AM.

Thank you all again for all of your help on brainstorming this.  You all
deserve fine chocolates :)

Debbie Gillespie, IBCLC, LLLL
Tempe, AZ

---------- Forwarded message ----------
From: Debbie Gillespie <[log in to unmask]>
Date: Thu, Mar 26, 2009 at 5:32 PM
Subject: Sky high triglycerides in breastfed infant?
To: [log in to unmask]


Hi All,

I’ve got a really quirky case that I’m not sure how to counsel.  Baby is 14
months old; still almost exclusively breastfed (family history includes
laundry list of allergies); 18 lbs. 1.5 oz current weight, down from 18 lbs.
13.5 oz at a year.  Mom is a long-time vegetarian and became vegan when baby
reacted to milk and egg in mom’s diet; she does take prenatals but no other
supplements.  Baby’s main source of nutrition remains breastmilk.  Ped has
been aggressively pushing solids and even formula supplementation for past
several months, but mom has resisted the pressure.  Infant reacts violently
to many different solids, so mom has been proceeding cautiously when
introducing any solids; baby is VERY picky.  Ped ran some blood tests
recently and the results have freaked everyone out:

 Cholesterol: 205 (Should be less than 170 for someone her age)

Triglycerides (fasting): 820 (Should be less than 150 for someone her age
fasting)

HDL: 20 (Should be greater than 45)

%HDL: 10 (Should be greater than 27)

LDL: Invalid with triglyceride level over 400

VLDL: Invalid with triglyceride level over 400

Cholesterol/HDL Ratio: 10.3 (Should be less than 4.5)

Breastfeeding and Human Lactation includes one paragraph about cholesterol
(it’s typically higher in a breastfed infant) and nothing about
triglycerides.  Lawrence’s book has three pages regarding cholesterol levels
in infancy but only for the first few months of breastfeeding, and nothing
about triglycerides. JHL has an article in 2/2003 (The Long-Term Effects of
Early Nutrition: The Role of Breastfeeding on Cholesterol Levels ) but I
suspect it’s going to reiterate the same info that’s published in the
textbooks (I admit I haven’t read the article but I’m trying to avoid
troubling ILCA any more than necessary).

 This obviously falls outside our area of expertise, but I’d like to support
the mother as much as possible.  Ped seems to be searching for any excuse to
get baby off the breast ASAP.  Has anyone come across such high cholesterol
and triglyceride levels before?  Let me know if you need any further info.

 Thank you in advance,

Debbie Gillespie, IBCLC, LLLL
Tempe, AZ

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