Luann, the most likely reason for a breast milk sample with low fat content
is that it was provided from a fairly "full" breast. The fat content
increases in proportionto breast drainage.
I agree that a 3 lb underweight is cause for concern. I've worked with a
long-term LLL mom who knew exactly what she was doing and had successfully
nursed three babies, and who then inexplicably had a baby who just didn't
gain. Whether it was because she was just busy and the baby reached a
point where her nutrition became too inadequate to sustain a good gain I
don't know, but it can happen. If the doctor is willing to wait a little
time I'd suggest nursing in the normal way, but for shortish times (not
more than 30 minutes) and then pumping whatever is left to drain the
breasts really well and stimulate increased production. The EBM of course
should be given to the baby, but cup, supplementer, spoon or even
bottle. But she should have it. And - this may sound a little heretic -
but if the baby is 5 months old now, could she not start on a few weaning
foods? A mashed banana here and there? The exclusive breastfeeding for 6
months recommendationis intended for babies who are gaining well - I think
that a baby over 4 months who is failing to gain would fall outside that
category.
Best wishes to your son, may he keep very safe. And to you. I can't
imagine what it must be like to let him go. Although my husband went off
to fight for his country 28 years ago, and that was just appalling!
Pamela Morrison IBCLC
Rustington, England
[log in to unmask]
At 05:20 03/02/2006, you wrote:
>Seeking wisdom and guidance from anyone who can provde it!
>
>Working with a FTT situation, with a 5 month old. The doctor ordered a
>breastmilk analysis, since mom does not want to offer formula and is
>interested in maintaining the nursing relationship. The baby started out
>doing well but began to fall off the growth curve around 2 months, but was
>only referred to me recently.
>
>The breast milk sample was not a 24 hour one, for obvious reasons and so it
>obviously has dubious clinical value (sigh!) however the tryglyceride
>content (I'm not sure why total fat content was not measured), is 90% less
>than it should be. Glucose, lactose and protein all WNL's. It was collected
>with a hospital grade pump, however I am unsure of collection container,
>transport, and what time of day sample was collected, etc. as I was not
>involved with that process. I've spoken to another doctor in the practice
>and he might be willing to give a bit more time to turn this around, however
>I am at a loss to try to interpret what these values mean and even more so,
>how to turn it around to have a thriving baby.
>
>Mom has sucessfully nursed other children and has made quality milk in the
>past. Can anyone tell me what the typical triglyceride level would be at 5
>months? I've looked in latest Ruth Lawrence, and did not come up with the
>specifics I am looking for.
>
>I know we have all seen some stressed out moms who are not nutritionally
>maintaining themselves. do any of you think that malnutrition and stress can
>decrease fat cotent to the point of these amaziingly low levels.
>
>There is more to this case that I could disucss, but seeking the most info
>on interpreting results and if this mom has potential for recovery of the
>fat content of her milk?
>
>Thanks everyone for any assistance,
>LuAnn Smith RN, IBCLC
>York, PA
>
>(Who's Marine son is deploying for the first time to Iraq next week!)
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