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Subject:	Re: sudden breastmilk refusal
From:	Ingrid Tilstra <[log in to unmask]>
Reply To:	Lactation Information and Discussion <[log in to unmask]>
Date:	Thu, 22 Jul 2010 13:38:13 -0600
Content-Type:	multipart/mixed
Parts/Attachments:	text/plain (713 bytes) , original_message.txt (3092 bytes)

If the problem is taste, perhaps changing that would help? Babies have been shown to like the taste of garlic, for example.

And maybe you could provide the HCP with accurate information about breastfeeding and surgery.

Ingrid

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Hi all~

I am stumped. I saw a mom this morning with a 4 month old baby who suddenly refused breastmilk at 2 1/2 months. The history is as follows:
This is her 4th baby, exclusively breastfed first 2 for about 7 weeks, but had supply problems. Breastfed 3rd child for 4 months with a much better supply. This baby exclusively breastfed from birth, but lost weight--vomiting due to pyloric stenosis, surgery at 2.5 weeks old; went right back to exclusive breastfeeding.

When baby was 2.5 months old, mom went in for same-day tubal ligation. Was told to pump & dump for 24 hours. Breastfed right before surgery, provided expressed breast milk for 24 hours. When she put baby back to breast, he latched, but pulled away at MER and fussed. Latched again, but pulled away again crying. Mom has continued to try to breastfeed baby, but baby pulls away when milk lets down. Is using Breastflow bottle, 4-6oz fmla every 3-4hrs. Another LC suggested mixing breast milk in small amounts into fmla. Whenever she does this, he refuses the bottle, no matter what the concentration. Even tried scalding the breast milk, still refuses. In my office, baby did latch, but pulled off soon. Tried to see if he'd stay on any longer with sns with fmla in it; worked for a minute or so, but then he pulled off fussing. This looks like a taste thing, not flow rate or supply issue. I asked mom if she's tasted her milk and she says it tastes flat. No sweetness, no real taste at all. Before surgery, nursing fine, after surgery, total breastmilk refusal.

Mom has no significant medical history, she is on no meds, no over-the-counter drugs, no alcohol, no tobacco. Her diet has not changed, her weight is stable, mildly obese. Warm baths, etc... nothing helps--will latch, when tastes milk, comes off. Baby is completely healthy. As I said, I'm stumped. I suggested analysis of a sample of her milk, but I doubt medi-cal will do that, and she doesn't have the resources. Mom is highly motivated, pumping & freezing her breastmilk.

Any input would be greatly appreciated!
Rosalyn Farley, IBCLC
CPR WIC
Sacramento, CA

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