Andrea
I know you are experienced IBCLC so forgive me if I seem to be asking the
obvious. But from your post I could not tell all the info. Have any test
weights been done? This is a case where they would be useful IMO. I have not
had a baby dx with malabsorption. So far in almost 30 yrs, in every case, a
poorly gaining baby, once definitively provided (by direct breast or
alternate route) with adequate volumes of breastmilk (or formula if milk
supply low) did gain weight quickly. So these would be my questions: did you
examine mother's breasts? what is the history re milk surge and previous
lactations if any? what is the history re birthwt, gestational age, early
weight loss patterns, jaundice, etc. Have you been able to determine
accurately what baby is transferring at breast? How long are the feeds?
I have seen several to many cases in which baby is just getting enough
volume / calories to maintain but not gain. These kids often are urinating
and stooling at least 6x/4x daily. Often the mom has a less than abundant
supply.
Please let us know outcome if you can.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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