I have a patient who is a one year old twin, born at 25 weeks, 1000 gms.
Had a rocky six months initially with many critical periods. She finally
came home at 6 months of age. Mom had tried to provide breastmilk for both
babies as long as possible. She is a breast cancer survivor and her supply
dwindled several months ago.
This baby has been on lots of meds, primarily steroids for broncho pulmonary
dysplasis and amoxicillin for kidney reflus. She is finally being weaned
from the steroids, but that process will take several more weeks.
The past three months, this baby has been awaking at night, crying as if in
pain. She has been hospitalized three times with low grade fevers,
vomiting, and slightly elevated white blood counts, but no cause was
identified. Each time she returns home, the crying, fever and vomiting
begin again. The parents kept asking for tests for yeast, but were
poo-poohed because she had no thrush in her mouth or on her bottom.
Finally, someone listened to them - - because they refused to take her home
again until an endoscopy was done. The scope showed patches of thrush in
her esophagus and erosions in her stomach. She is on Prevacid, Nexium and
Maalox, but still is in pain and not retaining much of her feedings.
Erythromicin has been added and the amoxicillin continues.
I have suggested finding donor breastmilk for her, hoping that would help
heal the erosions, be more easily absorbed and stabilize her weight. The
parents are exhausted and so is their baby. Is it worthwhile to pursue
this? Has anyone else ever come across this type of situation? Did
breastmilk help?
If Dr. Paula Meier is reading Lactnet, I would appreciate her insight. This
family is in suburban Chicago.
Comments would be appreciated. from anyone.
Diane Perrone, RNC
Materna Wellborn
Algonquin IL USA
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