Dear Chris,

Thanks for your reply.  Here are the answers that I know about.
>Is it possible to sit down and do a full diet analysis on both mom and child?

Full diet analysis has not been done.  Child was fed breastmilk exclusively
until approxiamately one month ago.  He was offered foods regularly from
about 9 months of age but chose not to take them.

  The mom's milk
>should be providing a reasonable amount of fat as long as she bfs.  I would
>also look into having a cremocrit and segmented fat analysis done on the
>mother's milk, but be careful not to put the "blame" on the mother's milk.

Mom's milk seperates readily and has a much larger than normal amount of fat
(so far unmeasured.)  In fact, the milk saponifies within 8 hours when
refrigerated immediately after pumping.  It does survive freezing if the
milk is put into the freezer within minutes of pumping.

>There's just as much probability that this is some congenital problem as
>her milk having been deficient.

Child has been diagnosed with congenital birth defects - Persistant Hyaloid
Vasculature on the right eye and has nystagmus.

> Is the baby of "normal" wt and ht parameters?

Birth weight was 8 #.  At 4 months he was 12# 10 oz.  After elimination of
his pacifier he grew to 18# at 6 months and 27# by 9 months.  He was 30# at
a year and currently 33#.  He is currently 34".  The child has been vomiting
after almost every feed since I first saw him at 10 weeks.  Vomiting
improved somewhat with the elimination of dairy in mom's diet.

  I'm wondering about the possibility of an absorption problem
>with fat.  Ask her about the baby's stooling history.

Baby's stools and gas have been relatively smelly compared to other babies
when exclusively breastfed.  Stooled on an average of once a week in the
early months.  From about 10 months he was stooling about every 3 days.
Currently he stools about 2x/day while eating lots of solids.  He eats about
3 cups of food per day.  He still nurses all night and 5 - 10x/day for about
5 - 15 minutes with lots of swallowing throughout entire feed.  He has begun
consuming 15 - 20 oz/day of water as well.

  If lots of fats are
>passing straight through, then this child needs to be evaluated for a
>variety of metabolic disorders.

Metabolic tests so far: T4, T3, T5H, and serum cortisol-am.  Tests were
within normal range.

Anything else you have add will be appreciated.  Thanks for the input so
far.  Mom will be sure baby gets her milk until at least 6 years of age.  If
anyone can ascertain that it would help after that age I am sure she will
continue to provide it for as long as it will make a difference.

Linda Pohl, IBCLC
Phoenix, Arizona USA
[log in to unmask]