Dear Senecca,

I have had two patients with MCADD breastfeed exclusively for 6 months [they
took L-carnitine too] Since you are past the first few days before the mom's
milk is in - you're good to go with that kind of weight gain. The mom needs
to know that the baby MUST eat q 3-4 hrs - No sleeping through the night.
The reason these kids get put on formula is that the docs are afraid they
aren't going to get enough, freqently enough, and since the docs can't
measure or see how much is going in it makes them very nervous which is not
unreasonable if you have  to take care of them if they're hospitalized.  If
the docs are nervous you can always do test weights - one of my moms test
weighed her baby for every feed - that was my compromise with the metabolic
doctor who wanted her to pump and bottle feed.  The important benefit of
breastfeeding in a case like this is the immune protection, because  you
know how babies don't eat well when they get a cold or worse yet for a child
with MCADD get gastroenteritis [automatic hospitalization].

Gail
Gail S. Hertz, MD, IBCLC
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----- Original Message -----
From: "Senecca Kirkhart" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, August 25, 2010 12:51 PM
Subject: MCAD and Breastfeeding


Do any of you have any experience with a baby with MCAD (medium-chain
acyl-CoA dehydrogenase (MCAD) deficiency, the most common fatty acid
oxidation defect) and breastfeeding?

Do they have to supplement formula?  Can they only breastfeed?  Are there
any supplements besides formula that work?

Historically, it seems as if these babies are put on formula.... and I have
worked SOOOO hard with this family, baby gaining great weight on breastmilk
alone!!  (At two weeks of age, is 9 oz above BW!!!)

Thank you in advance!
Senecca Kirkhart, CPNP
Lactation Specialist
Fuller-Roberts Clinic
South Boston, VA

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