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Subject:
From:
Ann Calandro <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 1 Sep 1998 11:12:39 -0400
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I would appreciate some input on this mom and baby and some guidance as to
what to suggest next.  This is going to be a bit long but I will try to put
in important details.

Baby boy born early February,1998. Birth Weight 6-12, 21".  Mom healthy,
second child to nurse, nursed first for 4 months.  Mom smokes 8 or less
cigarettes per day.
Discharge weight 6-8.

Well visit at 7 weeks of age- weight 10-1, 22.5 ".  Began fussiness and
exhibited "high need" behaviors,   also began having some small specks of
mucous and blood in bowel movements.  MD said give Mylecon gtts.  Parents
also began giving sips of water occasionally.  Well water has been tested
positive for colliforms (not fecal). Water was not boiled before giving to
baby.

Well visit at four and a half months.  Weight 13-4. Ht. 25".  MD said begin
solids. Parents began solids which baby accepted well, ate 3 times per day
after breastfeeding.  Began having trouble passing stools, mom used rectal
thermometer on advice of MD to help baby pass stools.  Began having bright
red stools.  MD said was from moms bleeding nipples (mom wasn't having
bleeding nipples).   LC encouraged mom to remove dairy from diet, and to
only breastfeed to give baby a break from the solids.  Baby began 8-10 loose
stools per day.  More mucous and blood in stools.
Mom took dairy out of her diet, which she does not feel has helped.

Five months- Weight 14-1.  MD dilated rectum with finger to "rule out
fissures".
Bleeding increased , diapers "alarming", and by 6 months baby having very
frequent bms every time he eats, weight up to 14-8.  Two weeks later, weight
14-5, Ht 25.5"
Baby has become very fussy, acts like he is having stomach pain, continues
to wake at night with screaming and does not accept the breast at times.
Bowel movements explosive, seems very unsettled when nursing.

Visit with gastroenterologist  last week.  MD said baby is allergic to
breast milk and that mother is making him sick.  Stated that baby is having
starvation stools, that mother must stop breastfeeding and baby must go on
special diet.  MD wants baby to undergo sigmoidoscopy this week.  Mother
very concerned, wants to continue breastfeeding, wants to find out what is
going on.

No stool cultures have been done.  Mom has requested.  Mom wanted to let me
know today that baby has been having frequent sweats and soaks his clothing
. (I just found this out today).  I would appreciate any help or suggestions
that might be made for this couple.  Baby will be 7 months old this week.
Appears bright, very pale skin, alert and friendly child.  Mother is stay at
home mom, 35 years old.

Where do we go from here?  Suggestions would be very much appreciated,
privately or through Lactnet.

Ann Calandro,RNC,IBCLC

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