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Subject:
From:
Alicia Simpson <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 27 Aug 2014 22:07:26 -0400
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​
I had not considered the mother's vitamin D levels, I see them again in 2
days and I will ask her. She was anemic during pregnancy and was put on
high dose iron in addition to her prenatals (65mg Fe BID + 27mg Fe in
prenatal). I had her get her iron status checked last week and it is in the
high normal range so she has discontinued iron supplements and is still
taking prenatal's. I've also added EFA's to her diet. No antibiotics were
used in labor, and the mother has no history of GI issues other than recent
constipation due to the iron supplements which has resolved since
cessation. Mom is currently taking probiotics but we have not tried any on
baby yet. Mom did call me this morning to report that after another round
of rectal stimulation in addition to mom drinking prune and pear juice the
infant had another bowel movement. This brings the total to 5 and all have
been after some type of rectal stimulation. They are also very large
(filling the diaper completely) but are normal in appearance and texture.

I was also able to open the lines of communication more with the
pediatricians today. They still are not at all concerned about any GI
issues and instead are focused only on weight but agreed that a consult
with a pediatric gastroenterologist  would be a good next step. The last 2
times they saw the baby were almost immediately after she had one of her
rare bowel movements so they have never witnessed the hard
and distended abdomen that I have.


Dear Lactnet Friends:

Thank you Alicia Simpson for you update on this interesting case. 40 ounces
a day is a lot for a little one to ingest.

What are the mother's Vitamin D levels? Is the baby receiving Vitamin D?
 What is the mother's gut history? Were antibiotics used in labor?

There is clearly (to me) something wrong with this infant's gut? Has a
trial of probiotics been helpful? Can a gastroenterologist see this baby?

warmly,

--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC

Take Care,

*Alicia C. Simpson MS, RD, IBCLC, LD*
Maternal and Pediatric Dietitian
International Board Certified Lactation Consultant

             ***********************************************

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