I am hoping that someone can help with a difficult case that I am involved with, I have permission to post. Baby boy 3 months old. Birht weight 9 pounds. Saw at 3 weeks with adequate weight gain but sore nipples and had yeast infection. Treated and gone. Mom went to Canada to see family for 3 weeks and came back saying he was pulling at the breast a lot. She had been dairy free also since the yeast treatment as baby was reacting, had positive stool cultures, and got better once mom was dairy free.

Upon coming back from Canada (1st time I had seen since 4 weeks old) he had only gained 2 ounces. Mom said he spit up a lot. We fed, she has a good let down but not overwhelming. She feeds on one breast unless he shows signs of wanting to change which is only on occasion when he is cluster feeding, etc. At all visits his intake has been right at 3 ounces at the breast. After about 5-10 minutes he begins to spit up slow amounts and then wants to feed again within 45 minutes to an hour.

Put on reflux meds. and stools got better as did fussiness after feeds but still vomiting. Verifying genetic screening at birth was done and correct. Labs run with elevated liver enzymes but bilirubinand everything else normal. Pediatrician is referring to a GI specialist. He did have a bought of blood in vomit while in Canada but she was damaged and they did not test the sample to see if it was fetal or maternal. Pediatrician says labs do not indicate a pyloric stenosis nor a metabolic disorder. She is hoping he does not have to be on Progestimil. Any help would be appreciated!

Thanks,
Emily Lindsey, BSPsy, IBCLC

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