Much appreciated colleagues,

The response about 10 days ago was tremenous in regard to this little girl who
isn't gaining. I so very much thank all who responded both for your
suggestions and your caring.  All e-mails were shared with the mother who
needs all the encouragement she can get.  I apologize for taking so long to
give all of you an update, I've been suffering from the IRS post-payment
stress syndrone with was preceded by the  pre-filing anxiety syndrone which
have now passed till next year.

Most of the suggestions have been tried or are presently being used.  For
those who suggested checking for GI problems or cystic fibrosis, the baby was
in the hospital for one week during November and these were ruled out.  About
the only thing that hasn't been checked is growth hormones and allergies.
Just as I last posted, I was starting to think allergies myself with the on
set of the second ear infections.  This is what we are focusing on now with
the top three in question being cow's milk, peanut butter and wheat.  She
gained 2oz this past week and her appetite has recently picked up quiet a bit.
HRS has put this case on a back burner for the time being although a social
work still makes a weekly visit.  The mother is meeting with a nutritionist
next week (she had an appointment several weeks ago, but the nutritionist had
to cancel due to her child being sick).  I'll try to keep all posted of any
progress.

An update on the mom that had mastitis that did not respond rapidly to
antibiotics. This was the mom that I felt was also suffering from ductal yeast
due to symptoms and nipple thrush (baby had thrush, too). She was in so much
pain she could hardly move her arm, yet had no lump or thick spot in breast
and she was running high fevers with chills even after being on antibiotics
for several days.  We feared an abscess deep in the breast that couldn't be
felt.  It was suggested to have ultrasound.  Mom went back to the OB and he
didn't feel ultrasound was necessary.  It did heal in about a week and she
continued on Diflucan about a week after finishing antibiotics.  Her supply in
the affected side had dropped quite a bit even though she was pumping
faithfully (to sore to put baby to) and she mentioned this to the OB and he
prescribed Reglan (surprise? his suggestion, not mine) and supply rebounded.
Saw her the other day and she is all smiles.

Thanks so much for being there to brainstorm these with me.  You are all
wonderful.

Warmly,
Pat