In a message dated 97-02-13 21:06:13 EST, you write:

>From:    Khalid Aziz <[log in to unmask]>
>Subject: Spitting up breast milk
>
>Ann,
>
>I would be concerned about a child who was vomiting at 4 days of age and
>becoming dehydrated.  The differential diagnosis is wide and includes some
>serious conditions that need assessment by a physician.  These include:
>
>1)  Infection, particularly urinary tract (rare)
>2)  Gastroesophageal reflux (common)
>3)  Congenital abnormality of the GI tract (rare)
>4)  Pyloric stenosis (rare at this age)
>
>I suspect that the vomiting is unrelated to the breastmilk unless mom is on
>some unusual medication.  There may be no serious problem here but is
>suggest the child see a physician soon.
>
>Khalid
>
>Khalid Aziz
>Memorial University of Newfoundland
>
>
I would like to add a REMOTE possibility.   I have recently been involved in
a situation that started with the baby spitting, progressed to lethargy and
jaundice, mom had copius milk and an incredible let-down.  He ended up in ICU
with seizures....due to Citrulinemia.  I may post more detail later but let
me just give the basics for now.  This is from an inborn error of metabolism.
 Just as we know about PKU from inability to process the amino acid
phenylalanine, Citrulinemia is from an inability to process the amino acid
argenine.  This situation results in an extremely high level of ammonia in
the blood, a very sick baby and ensueing seizures.  There has been recent
research on this topic and fortunately this baby has received wonderful care
from one of the docs that apparently was an original researcher(no quote on
that, not sure of all the connections). This baby has been able to stay on
exclusive breastmilk, carefully calculated and a medication that helps with
metabolism of the argenine.  I guess what i'm getting at is that it is easy
for us to look for simple "fixable" answers, especially for something that
sounds so simple.  I've read so many of the posts so close together that I
can't remember the original situation....but dittoes to watching the baby for
actual intake, output, signs of hydration and overall well being.