One more
>thing--her baby appears to have a dairy sensitivity and mom has not yet fully
>eliminated dairy--I am hopeful she has done so as of today, as her baby is so
>gassy, it is difficult to tell how much this is affecting feeding and
>stooling.

I find that a food sensitivity often causes a baby to feed poorly at the
breast.  She will begin to feed, suck shallowly, come off and on, cry in
pain, and generally feed for a short time, just to want to feed again.
This same baby will take a bottle of mom's milk with ease. I believe that
it is caused by the smell of the offending food on mom's breast.  The milk
from the bottle still causes the painful gas in the baby but the bottle
doesn't smell like the culprit. [We do smell like what we eat and drink.]
The fact that this baby sometimes has a "good" feed, may be due to this
factor.

If mom knows clearly that her eliminating *all* dairy foods will help her
baby to feed at the breast better and to gain more weight, she will be able
to take the necessary steps to eliminate the foods.  Of course, there may
be other foods, but beginning with dairy, along with eliminating the
ferrous sulfate that is in her prenatal vitamins and any nutrasweet
(aspertame) in her diet, is a good place to start.

I have had several clients whose babies weren't gaining weight even with
adequate volume of intake, but when offending foods were removed from mom's
diet, baby began to gain weight.  Joy A. mentioned this too, and I got the
suggestion from Lactnet a few years ago.

So, my big question---would it be beneficial to continue the Reglan
>at the original dosage, a different dosage or in combination with something
>else (oxytocin spray?). I think this baby would do well if mom's milk supply
>came up.

But not if the food sensitivity issue isn't addressed.

I suggest the food elimination first.  Reglan can be risky if continued
over an extended period of time.  The last thing that this mom needs is a
psychotic break.  Depression is not a side effect to be taken lightly.

You could recommend that she look into getting Domperidone from our
"Canadian connection" if the food elimination doesn't help enough.  I have
3 mothers taking domperidone for an extended time with good outcomes.

Pat Gima, IBCLC
Milwaukee, Wisconsin
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