Terri,
I am certainly no expert on vit D deficiency, nor calcium and phosphorous
levels. However, what I think happened is that a 3 day old baby had bf
problems such as:
1. not nursing well / poor latch
2. not nursing frequently enough
3. mom's supply somewhat delayed due to above 2 factors
(I do not have the baby's gestational age nor birthweight and subsequent
weights, but that would be helpful to me). What I think happened then is
that baby was admitted to hospital for hyperbilirubinemia (as you said) but
also dehydration and his electrolytes were tested and his sodium(and
possibly other electrolytes) was probably elevated. Then the doctor decided
to test the breastmilk, thinking erroneously that the breastmilk was somehow
abnormal. Instead of thinking that it was LACK OF INTAKE that caused the
hyperbilirubinemia and the dehydration. In doing this milk testing, he or
she found low levels of phosphorous - (do we even know what normal levels
are?) - and even if low, would this cause the above problems in a 3 day old
infant? I say NO. While I do not dispute that rickets occur, and that vit D,
and other minerals may be deficient in some maternal diets, I believe
rickets and other derangements would occur over a longer period of time, not
in 3 days.
You say mom's supply has "come in" now, so I would want to assess how her
supply is doing, and if it's in good shape, then the main thing is to make
sure baby is nursing well and often.
I think things are getting off track, for mother to feel she needs diet
counseling and milk testing. Again I ask, do we know what normal levels are
anyway, and if the testing method is in any way standardized.? I say this is
a case of looking for zebras when the horse is right there in front of us.
Good luck with your IBCLC plans and glad you are back on track for it after
your surgery.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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