Dear Colleagues,
I am working with a mom who has given me permission to ask for your input.
She took glucophage prior to and throughout her pregnancy because of a fertility
problem caused by insulin resistance. He baby is five months old and has not
gained weight in over a month. The month before that, baby had gained only
minimally. After taking an extensive history and assessing a feeding episode, our
first suggestion was to get her to resume feeding from both breasts each
feeding, which she had stopped after what she called a "projectile vomiting"
episode. The doctor had encouraged her to feed the baby formula and if not that, to
fortify her breast milk with Human Milk Fortifier. I just got a message
passed along that the baby had a "sweat test" that indicated that baby had kidney
problems and the parents are taking the baby to a major children's hospital in
a neighboring city.

The questions I have on my mind, (1) Could baby experience side effects from
the glucophage that would involve the kidneys? (2) Could inadequate milk
intake affect the results of the "sweat test"? (3) Does insulin resistance
significant enough to affect fertility also cause difficulties either in milk
production or calorie (milk fat) content?

I probably won't hear back from this family for a while, but I would
appreciate any information or suggestions that you may be able to offer. TIA
Kathy Bowers,  hospital based RN and IBCLC

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