Julia

Welcome to LACTNET!  I'm sharing Heather's sense of mystery about 
what could be happening here.  My first thought - assuming that baby 
has been having at least 8 wets and 4-5 large stools daily is that 
there must be an error in one or other of the recorded weights.  A 
baby who has lost 14% of her birthweight would not be producing this 
output.  And I agree that stopping BF would not help celiac disease, 
even if that were the diagnosis.

As a first strategy, I'd probably suggest a face to face consult so 
that you can re-check the weights, and do a nursing exam to assess 
milk transfer and _see_ what the mother means by a wet diaper and a 
large stool.  If all seems well then it would not be up to the 
paediatrician to "want" this baby to receive either breastmilk or a 
breastmilk substitute on an unknown diagnosis...... if you're not 
able to actually discuss this case in a friendly way with the 
paediatrician himself, then I'd recommend the mother receive a second 
opinion from a known baby-friendly doctor before making a decision 
about whether _she_ wants to stop breastfeeding, or not.

However, you might find that things are not as good as they sound on 
the phone and the paed might be justified in wanting to start formula 
supplements because of the large weight loss.....

Rather a lot of 'ifs' in there...... :-)  Good luck!

Pamela Morrison IBCLC
Rustington, England
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This is my first post... I read your wise words daily and I now have 
an odd case that I need help with. Mom of a 10-day-old called me in 
tears; pediatrician just told her to stop breastfeeding, pump and 
dump, and feed formula because child has lost a lot of weight (8lbs 
4oz at birth, 7lbs 1 oz 10 days later.) Baby is not vomiting/spitting 
up at all and according to mom, has at least 8 wet diapers and 4 or 5 
large stools daily.  Pediatrician's concerned it may be celiac 
disease (no family history other than a distant aunt with the 
disease) so he says he doesn't want her nursing at all anymore until 
they've tested the baby.  First of all, what tests will they do to 
determine celiac in a newborn? Second, what am I missing? I thought 
recommendations were for mom to continue nursing until it's 
confirmed. And I also thought celiac usually takes some time to 
develop and will likely not show up until introduction of first 
solids/gluten.  And third, what else could we likely be facing here, 
with normal outputs and a significant weight loss?

I'm probably leaving out important info in this post... and I'm 
fairly new at this so I may not even be asking the right questions, 
but I guess I have to start somewhere right? Thanks in advance for 
any help or advice you can provide!

Julia Amos, MPH, IBCLC
Milwaukee, Wisconsin
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