Dear brilliant lactnetters.

Can someone please give us some input for a mother who is desperate.

First pregnancy, assisted fertilization. Baby girl born at 2600g. Term. She is now 9 months and 6100 g.
Since she was born up to this day, she never showed hunger cues.  Mother said that the baby only managed to stay a couple of minutes at the breasts when she was breastfeeding. Mother was taking Sulpiride since the first week after birth until weaning and that might have helped keeping her small supply since baby's suck didn't seem to do it alone.

Mother and baby were separated at 3 weeks when mother had to go back to college 3 mornings a week. Mother was expressing milk, and milk was given by bottle by the sitter. Slow weight gain. Very strong nipple preference since the early months. Mild reflux diagnosed on the 2nd month, baby was prescribed domperidone.

 At 3 months she called me to tell me her baby didn't have one single feed on that day. I sent her to her ped for urgent evaluation. Nothing wrong he said. On the 5th month baby only gained 50 grams. Doctor order was to give up breastfeeding because "she would gain better with formula". On the 6th month she only gained 60 grams on formula. Baby is allergic to cow milk protein. She was given soy formula. Head circumference is not within normal limits. Started her on solids and fruit juices. She refuses to open mouth, mother tries anyways, and says she manages to feed 2 or 3 teaspoon and a little juice. Doctor said to add oil to formula and solids for a better weight gain.

Now the situation is a lot worse. The baby is vomiting after each feed (formula or solids) and has been doing this for *3 weeks* now. She started that in December when they went to Florida to visit family with mom and dad.

She does have about one dirty diaper everyday but mother said that she doesn't see that she is urinating much. (no heavy diapers) What I see is a sad baby, who looks at you directly in the eyes like she's hypnosed. Obviously if she doesn't eat anything, she doesn't have energy to spare doing what a typical 9 month old would be doing.

I am thinking she could be one of those "bucket babies" who don't receive enough stimulation and who lacks being touched and held. At the meeting yesterday the mother came with her in a stroller and didn't took her out of it in the 2 hours that she was there. The baby was awake during the meeting but there was no interaction or play with the mother except to offer a carrot juice in a bottle, without
holding her. No toys were offered to her while she sat in her stroller.

This baby doesn't hold a sippy cup or a bottle by herself. She doesn't crawl but if you put her on her stomach she can hold herself on her hands and knees. Mother said that Dr told her that motor skills are fine.

Baby had Xrays of the stomach and everything was normal except for the mild reflux at 2 months which I guess the Dr sees resolved because she stopped giving domperidone for reflux many months ago.

What makes me very worried is that this baby never showed any interest in eating. Could she have an ulcer or something that makes it so painful to eat that she decided to avoid it altogether? Can they not see this on a Xray?Or can this baby be anorexic? I remember reading something about this a while ago but cannot remember the source.

Can some of you see something else here? Please let me know everything and anything you can think of as this mother is at her wit ends.This baby has been seen by a specialist in infant nutrition, a gastric Dr, her regular ped and another ped. They all acknowledge that the head circumference is too small and the weight gain is very slow. I hope this is not too off topic as it isn't quite a lactation situation but I feel someone might be able to help. Please reply to me directly as well as the list.thanks!


Nathalie
LLL of Chile







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