I met with parents of an 8 wkold baby this week.  The baby was fed ABM
initially, then mother wanted to breast feed. Breastfeeding seemed to be
going fine, but on exam at physician's office there was blood in the
stool 2 week check up.  Mother was told to go off breastfeeding, pump and
eliminate dairy from her diet.  Mother is Lactose intolerent and phys
thought baby was too.  All was well until a GI specialist was called in
and now 8 week old baby was scoped and has colitis ulcerations  visible
on scope.  GI doc says no breastfeeding, Alimentum only.  Mother wants to
pump milk to keep up supply.  She is now removing all bovine protein at
my suggestion for the next two weeks.  The GI will see the baby again in
two weeks.  When I spoke to the GI specialist he told me not to encourage
her to try breastfeeding because the baby is definitely having a problem
with something in the mother's milk.  Pediatrician told mother she could
breastfeed.  I gave her information and told her it was her decision, but
if it were me I would breastfeed or at least re address the situation in
two weeks when I saw the GI specialist again.  The GI specialist was
adamate that I discourage her from breastfeeding.  She sat in my office
and breastfed.  I did not encourage or discourage the breastfeeding.
What would you do.  I am not familiar with the GI specialist.  He was
nice enough and listened to what I had to say and I did tell him that I
would encourage her to eliminate bovine protein and ask again about
breastfeeding on two week f/u visit with GI specialist.  Have I gone too
far?  He did not sound adverse to me sending him information and I am
using Ruth Lawrence and Riorden& Auerbach.  Any other information you can
think of me sending to all physicians involved and the parents too.  I
will be speaking with the parents Monday (1/24) to see what their
decision was.  They rented a pump and were unsure if she would just
breastfeed, pump and save for later use, pump and dump and use specialty
ABM.  Sorry this is so long and hope it is making sense.  TIA in advance.
Darlene Breed, BSN, RN, IBCLC
Milk Bank & Breastfeeding Center
Worcester, MA (USA)

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