Hello Wise Ones,

I have permission to post.

I have been working with a very dedicated mother and her daughter for about
3 months now.
Baby was born in early June weighing 6lb.8oz, she had an unmedicated NSVD,
skin to skin right away.  Mom's nipples inverted with stimulation; nipple
shield started in the first few days, some formula supp at hospital.  I was
consulted at 10 days of age and found ULT and TT which were revised by Dr
Kotlow just before 4 wks of age.  Nipples were everting at this time.
Things went pretty well for the next few weeks.

Sometime between 6 and 8 weeks of age the baby's stool became dark green
and mucuousy with occasional spots of dark red blood.  Peds told the mother
that green stool is nothing to worry about but that the blood might be due
to a dairy allergy- so this mom began eliminating dairy from her diet.

At this point, about 2 months of age, the baby weighed 8lbs 12 oz.  Over
the course of the next 2 weeks, the baby started vomiting large amounts "
full of curds and white string".

At age 2 1/2 months this little one weighed 8 lbs 5 oz. and a day later on
the same scale ( peds) weighed 8 lbs 1 oz.  The pediatrician did testing
for bacteria and parasites which were negative and consulted with a peds GI
at our local teaching hospital.  No allergy testing was done.
Peds gave order to d/c breastfeeding ( mom is still pumping) and put on
pedialyte for a day and then this was mixed with Neocate and then full
feeding with Neocate.
Baby weighed 9lbs 5 oz after 1 week on Neocate only.  Vomiting stopped;
stools became more like what they were at 4 weeks of age.

WIth this "success" peds told mom to give Neocate every other feeding and
put baby back to breast otherwise.  Baby took to breast eagerly!
After second breastfeeding, baby's stool is mucuousy , loose and baby is
vomiting again!

Mom has no history of food allergy, but Dad's family has Chrohn's/ colitis
history.
My questions:  Did this baby gain slowly in the first 2 months ( 2 lbs in 2
months) due to TT/LT, inverted nipples and then the vomiting / green
mucuousy stool due to oversupply ( mom finally well emptied/ stimulated )
?  Or might there be an allergy to something in the BM?  I suspect this.
How do we figure out what it might be?
Any other thoughts most WELCOME!
Mom is still pumping ( and concerned about flange size) while waiting for
baby to be ready for her milk.
Thank you,
Helen Hoctor, BS, RN, CLS

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