Here is an exerpt from an article I authored for the Oregon LLL Area
Leaders Letter this past Fall.  It is part of a much larger article which I
have been asked to write for LEAVEN.  If you use this, please attribute the
authorship accordingly.


Phenylketonuria (PKU)
        PKU testing, although common, is not without controversy.  The test
is targeted at identifying infants who, because of a liver enzyme
deficiency, cannot metabolize phenylalanine, one of 20 essential amino
acids.  Without this early identification, PKU infants usually fail to
develop normal neural pathways in the central nervous system and brain.
The validity of performing mandatory PKU tests 48 hours after birth has
been questioned because of the high false negative rate, so a second test
is usually performed at the two week check-up.   In babies testing positive
for PKU, at least one more test should be performed to confirm results.
        According to Riordan and Auerbach,  "Breastfeeding an infant with
PKU is not contraindicated as was previously believed.  Human milk has
relatively low levels of phenylalanine," when compared with
low-phenylalanine formulas.  Miller and Chopra  and others  recommend that
total or partial breastfeeding should be encouraged in the PKU infant.  In
addition, these infants should have their phenylalanine blood levels
monitored regularly.  Leaders might forewarn mothers to watch for thrush
and/or nipple yeast because PKU infants are more prone to yeast overgrowth.

 Riordan, J and Auerbach, K.  "The Ill Breastfeeding Child,"  in
Breastfeeding and Human Lactation. pages 498-500, 1993.
 Miller, SA and Chopra, JG.  "Problems with human milk and formulas,"
Pediatrics, 74 (supp): 639-47; 1984.
 Brewster, D.  You Can Breastfeed YOur Baby...Even in Special Situations.
Emmaus, PA:  Rodale Press, pages 195-98, 1979.
 Lawrenc, R.   Breastfeeding:  A Guide for the Medical Profession, 4th ed,
page 348, 1995.
 Riordan, J and Auerbach, K.  "The Ill Breastfeeding Child,"  in
Breastfeeding and Human Lactation. pages 499-500, 1993.
 Mohrbacher, N. and Stock, J.  "The Baby with Special Physical Need," in
the Breastfeeding Answer Book.  Schaumberg, Ill.: La Leche League
International,  page 224, 1997.
WarmLLLy,

: )Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC  email: [log in to unmask]  : )
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