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Subject:
From:
Susan & Moshe Srebrnik <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 30 May 2000 16:17:23 +0200
Content-Type:
text/plain
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I would appreciate any input on the following case:

27 year old primapara, HCP, highly motivated.  IVF due to male
infertility.  No allergies/food sensitivities in either family.  Baby
born 37 wks. vaginal delivery with epidural.  Apgar 8/10.  A bit blue at
birth and given O2. Mother claims baby was very lazy nurser in the
hospital.  After 1 week of bf, mother began supplementing with EBM.
From week 1 to week 6, the baby nursing plus EBM and gained on average
10-20 grams per day.  The pediatrician told her to supplement with
Similac.  The baby began to show blood in the stools which increased
with each bottle.  The ped then switched her to soy-based formula as a
supplement which the baby vomited from + diarrhea.  The mother then went
back to bf + EBM.  THe baby lost 20 grams in a week.  Now the baby is
breastfeeding and getting supplemental Nutram'gn twice a day 120-150 cc
per feed.

This baby is really worrying me.  He looks very scrawny and is clearly
FTT.  He does not milk the breast well at all.  It is almost as if he is
giving up.  He does enjoy being on the breast for comfort.  If it was
just a problem of a baby not doing well at the breast, why wouldn't he
gain on expressed mother's milk?  Why only 10-20 grams a day being fed
10x per day?  Another red flag is the baby's severe sensitivity to
formulas.  I am sending the baby to a specialist and suggest blood
work.  PKU test was neg.  Blood glucose levels normal.  (Mother had
gestational diabetes from week 34.)  Baby does not appear "floppy" and
suck is coordinated.  I have take the mom off of cow's milk although
being a vegetarian, she isn't thrilled with the idea.  The mother will
not go for an SNS.

Any help would be appreciated.

Susan Nachman-Srebrnik, IBCLC
Ranana, ISrael

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