Hi all,

I'm Amy, I'm new to the list. I'm currently pursuing my IBCLC.  I've got a couple questions that I'm hoping you might have some thoughts on (with permission from mom to share her situation).

Mom has prior experience breastfeeding her first child for ~6 weeks.  Complaints of low supply and clogged ducts led to the switch to formula.

Breastfeeding was initiated after cesarean birth.  In the first 16 days postpartum, thrush developed in both baby and mom and was treated with Nystatin for the baby and fluconazole for mom.  Mom also tried gentian violet on her nipples, along with Newman's APNO.  She also experienced multiple clogged ducts.  Left breast was Dx with mastitis.  Due to thrush Dx and intense pain, mom stopped feeding at the breast and began pumping every 3 hours around the clock.  She averaged 1-1.75oz (total) per session.

Baby was born at 6lbs 15oz; at 4 days old, 6lbs 9oz at pedi appt; at 10 days old, 6lbs 13oz at pedi appt.  At 4 days old, mom was told by pedi that baby had lost too much weight and needed to be supplemented w/ formula [in my opinion, this is the beginning of all of their problems!]

Blood was found in baby's stool shortly after supplementing w/ formula began (not prior). Pedi switched them to Alimentum and advised mom to cut all dairy out of her diet on the suspicion that baby has a milk protein allergy.

Mom returned to pedi several days later when baby began choking/gagging/pulling off the bottle during feedings.  Pedi suggested that mucous might have been collecting in baby's throat and advised giving sips of pedialyte before and during bottle feedings to "clear the throat."  Mom was also advised to give a bottle of straight Alimentum, instead of mixing the ready-to-feed liquid Alimentum half/half with expressed breast milk.  Mom refused to try either of these suggestions, as she was not comfortable offering pedialyte and did not thing giving straight formula would help.

Mom continued to pump and feed EBM, along with Alimentum supplements (feeding about 1-1.75oz EMB and supplementing with Alimentum to reach 2.0oz).  After a couple weeks of pumping, she felt emotionally and physically ready to put baby back to the breast.  He latched right away and had a successful feeding.  At the next two subsequent feedings, mom developed blisters on both nipples.  She switched back to pumping, but intense pain and more clogged ducts led to discouragement, which led her to abruptly wean.  Weaning led to Dx of bilateral mastitis, treated with 2 antibiotics and a steroid shot for pain.

Baby is still experiencing choking/gagging episodes, and is now occasionally projectile vomiting.  Pedi Dx reflux and baby has been on various combos of zantac and nexium.  Pedi also had mom switch to EleCare formula.  

Pedi referred baby to a GI specialist, who wants to do a barium swallow study.  Mom sees the problems as intensifying as soon as she quit feeding breastmilk and went to 100% formula.  She is considering relactation for this reason.  

So, I'd love to hear what any of you think. 

Also, mom is near New Orleans, LA - can anyone refer a seasoned IBCLC that would be willing to work with her? There are a lot of cooks in the kitchen on this case now, but no IBCLCs.  (Mom has seen lactation pros at the time of delivery and spoke with an LC - not sure if she was an IBCLC - at a boutique, as well.)  

Thoughts? Feedback?  Apologies for the novel I just posted and thanks in advance for any replies you may have.
Amy



Mom was pumping every 3 hours around the clock

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