PTP – I have Patient with a 7 week old who is exclusively breastfeeding.  Baby breastfed well in the hospital.  Mom came in for an office visit on day 6 because baby starting having latch problems when milk came in.  Birth weight was 9 lbs 1ounce.  She was 8 lbs 10.8 ounces on day 6.  I helped her with position and latch.  Baby took in 1.7 ounces from breast.  Mom scheduled a follow up appointment for 1 week because she wanted to make sure everything was still going well.  Baby weight 9 lbs 5.3 ounces (gain of 10.5 ounces in one week!) and baby took in 3.2 ounces on day 13.  Up until day 13 baby was having 6-7 stools a day.  It was on day 13 that she stopped stooling.  She went 8 days without a stool.  Pediatrician had mom give a rectal suppository.  Mom states after giving the suppository baby went “6” diapers full.  It was another 7 days and baby had not stooled.  Mom said baby was fussy at this point, and not eating well. Pediatrician had mom give another suppository.  Again another larger amount of stool.  They have now been referred to a pediatric gastroenterologist 2 hours away who has ordered a barium swallow which was normal.  They are to have a barium enema 9/6/12.  They go back to see the Ped GI doc on 9/10/12 and if the BE is normal they want this mother to quit breastfeeding and pump for 2 weeks and give a hypoallergenic formula………the doctor’s thought process is this baby may be allergic to either her mother’s milk or something in her diet.  She has already eliminated all dairy, eggs and nuts of all kinds.  In the mean time the GI doctor has mom giving a suppository every day to the baby.  Mom states all she has to do is touch the suppository to the baby’s rectum and she will go.  Baby will not go without this stimulation though.  I asked mom to describe the stool and she said it was like really soft serve ice cream with seeds in it. The other thing the doctor has mention to this mother is Hirschsprung disease.  I thought Hirschsprung’s would have shown up on day one?  This mother really does not want to put her baby on formula!  She doesn’t feel like she has the support from her husband to question the doctors.  He says whatever the doctors say is best they should do.  She has called our office for advice.  Seems to me if this baby was having an “allergy” to her mother’s milk, the stools would be bloody, mucousy, and diarrhea.  

 

I appreciate any an all help you wise ones can offer.  We seem to always be defending breastfeeding and breastmilk!  Why is breastmilk always the root of all evils?

 

Debra Knight, IBCLC

Albany, GA

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