The main concern should be that the infant does not fast. The pubmed references I checked mention introducing toddlers to a low fat diet, and caution to avoid infant formulas that have medium chain triglycerides as their primary source of fat ( I don't know what ones these are). That said, I had a few patients with MCADD and they breastfed, I wish they could have for longer, because even minor illnesses in small children cause these kids ( and their doctors) a lot of problems. The mom does not need a special diet to make milk for her baby.
I'm posting this to Lactnet for continuity.
Gail Hertz
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> On Dec 2, 2013, at 3:41 PM, Michelle Scott <[log in to unmask]> wrote:
>
> Thanks Gayle, I totally agree with you and so does my colleague who's working with this mom/baby. But our question is really: due to the MCAD, is there any concern that the mom would not have all the fats necessary for her breastmilk? I don't think she is on a special diet. thanks again, michelle
>
>
>> On Mon, Dec 2, 2013 at 3:19 PM, Gail Hertz <[log in to unmask]> wrote:
>> Michelle,
>>
>> I would treat that baby like any other and nurse more frequently, supplementing with moms expressed breastmilk by spoon or syringe. Donor milk would be the next choice, and lastly formula-hypoallergenic preferred. It is important that the baby is fed when hungry due to the MCADD. Help this mom build a good supply by having her pump whenever she finds it necessary to give formula. Otherwise she will lose her supply bit by bit by supplementing without removing the amount of milk from the breasts that the baby is really drinking. Key for any mom to know: Breastmilk is a use it or lose it proposition- if you don't use it(leaving it in the breast instead of putting in in the baby, causes the breast to send a chemical and mechanical message to the breast to stop producing so much milk) you will lose it.
>>
>> Gail Hertz
>> [log in to unmask]
>>
>> > On Dec 2, 2013, at 9:42 AM, Michelle Scott <[log in to unmask]> wrote:
>> >
>> > Hello lact-sisters, we have a baby who is bf, a newborn, whose mother has
>> > MCAD--medium chain Acyl-CoA dehydrogenase defiency. The baby is fussy and
>> > everyone is assuming he/she is still hungry (aren't all babies hungry at
>> > this age of <1wk?). If indeed baby is not getting sufficient hind milk,
>> > what would you supplement the baby with? I would defer to those of you who
>> > work in NICUs.
>> > Please email me directly if you can, I am away from home, and computer
>> > access is not readily available, but I have my smart phone. thanks.
>> > --
>> > Michelle Scott, MA, RD/LD, IBCLC
>> > Pediatric Dietitian/Lactation Consultant
>> > [log in to unmask]
>> > 603 801-9140
>> >
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>> >
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>
>
> --
> Michelle Scott, MA, RD/LD, IBCLC
> Pediatric Dietitian/Lactation Consultant
> [log in to unmask]
> 603 801-9140
>
> Confidentiality Notice: This email message, including any attachments, is for the sole use of the intended recipient and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by email, and destroy all copies of the original message.
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