On Thursday afternoon I spoke to a mom of a 9 day old on Soy formula because
of mucusy running stools on cow's milk abm. The baby continues with mucusy
stools with were hem positive in the office the previous day. Baby also has
bad diaper rash and mom was feeling badly for her.
Stool WBC were negative but since I don't think the baby's small anal
fissure is the cause of the blood I suggested an elemental formula, sending
a stool culture and checking a CBC. I told mom her choices of elemental
formula and to give informed consent said "or you can try lactating" To
which mom said "Can I still do that" We talked some and arranged an
appointment the next day.
Yesterday I met with mom who says her husband is supportive, she did get the
baby to latch for a few sucks the night prior and she had bought some
elemental formula and said "I can't afford that"
Encouraging also is her post partum hx of developing engorgment on day 4 and
not feeling relief until day 8 so this mom was only 2 days from
lactogenesis.
One of my nurses, who should sit for her IBCLC exam b/c she is very good,
got an SNS attached to mom and the baby latched wonderfully. Mom and Gmom
are very into herbs and like the feenugreek/ blessed thistle idea.
I gave mom some of Jack's handout and a number for pump rentals and a LLL
number. My nurse will call her today and an office visit is scheduled for
Tuesday.
This is the first time I've done this.
Some questions. If mom feeds the baby 8 or more times a day with the SNS
does she need to pump?
How to wean off the SNS? When she can pump visable milk or we can tell the
baby is swollowing milk without the SNS?
-Rob
PS: CBC shows increased eosinophils


Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
mailto:[log in to unmask]

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