Lacnetters,
With permission from this mother I'm asking you for advise and thoughts.
I first received a phone call from this mother on Jan 2.  She said her
3-1/2week baby girl has colitis.  She had just come from a dr's appt. where
the baby had been weighed and was not gaining weight.  She was gassy, crying
with a high pitched cry, pulling up her legs, having yellow, loose stools
many times/day.  The stools were mucousy, watery, not the cottage cheesy
consistancy.  The mother really felt that the baby was crying in pain.  The
stools were tested and had blood in them.
I heard all this and thought of overactive supply and that the dr. was on
the wrong track until I found out that the dr. is a person that is very
supportive of BF...  The ped told her to hold off on breastfeeding and start
Nutramigen.  I added that dairy products are most usually the cause of
problems described this way.
On Jan 6, mom called me, she was off the dairy, she had gone on line and
found a list of foods that were dairy and derivatives of it.  She watched
the foods and stayed away.  She began breastfeeding again the day before and
said that the baby was much better.  She was relieved, but was still talking
about the baby gulping, so wanted me to see the latch and a feed.
On Jan 7, she came in and I watched the latch and gave some advise which
she took to improve the latch. I didn't see any gulping and those symptoms
of overactive let-down. Again she commented that the baby was better, but
hard to burp, sometimes cranky and fussy.  It was hard to console her
sometimes.  She had rented a scale and the baby had gained 4 oz since the
original call.  We were happy with this news.
Jan 8, she saw the dr. again and the baby still had blood in her stool, so
the dr. asked her to keep feeding Nutramigen for another week.  Mom kept
pumping, and feeding the formula.  The baby was dramatically more
comfortable.
Jan 13, she called me to tell me that tomorrow she was going to start BF
again.  She was nervous and wanted to know how she should begin again.  I
reassured her and suggested she just put baby to breast and call if there
was trouble.
This afternoon she called me, she had seen the dr.  Baby's weight is up,
baby is much more calm and feeding better. The mother was off all dairy
(according to the list)  The dr. told her to resume BF. She began at 2P.
This was 4P she called me, telling me that the baby is again drawing up her
legs and crying with the high pitched cry.  She also wanted to eat
frequently, ie, q 1-1/2 hrs.  She was worried that the same pattern was
occuring and should she continue?  The baby had not stooled yet.  I
suggested she continue as long as the baby was comforted by breastfeeding
since it seemed too soon to see such a change. The pattern of eating
frequently could be normal.  The dr. had sent home a hemmocult tester.  I
suggested she test the first stool she gets since resuming BF, if it's
positive, quit, if not test again in 24 hrs. That I would go to this drawing
board for help. I would be in touch with her tomorrow at the 24 hr mark.
Anyone have input?  Suggestions?  Mom is very distressed that her baby
looks as though her milk is causing her damage.  This isn't suppose to
happen!!  I'm up to hear from any and all of you!  Thanks so much.
                      Betsy Wells-Gephart RN, IBCLC
                      Chandler, AZ, USA






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