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Subject:
From:
laurie wheeler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 25 Jan 2000 07:48:51 PST
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Darlene,

These are the *really* tough cases. I was not clear from this part of your
post, when was blood was found, and why the baby was examined.
<<8 wk old 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.>> Was the
baby bf at 2 wks? Was the checkup 2 wks after bf commenced, when baby was 8
wks old?

In any case, is the child really *sick*? Is he gaining wt and developing
well? I understand that *sometimes* babies do better on a short-term use of
elemental formula until the allergen is identified and removed from mom's
diet. Could the baby be on mixed feeds like some alimentum and some bf?

As to what is your role in this matter, it is to provide info and counseling
and to support the mother in her *informed* choices. If she chooses to cont.
bf, then you will be counseling her re dietary changes, continued f/u with
the docs, etc. If she chooses to pump and save or pump and dump, then you
will be helping her commence w/ regular, effective milk removal and storage
etc. Lots of emotional support as well, and maybe putting her in touch w/
another family who has been there. Finding her lots of info so she can read
and discuss it all w/ the docs. Certainly, the decision is hers. If the pedi
differs in his advice from the gi doc, then obviously it is up for
discussion what the best course of action is.

Everyone should consider that curing the gi bleeding (again, how
severe is this?) should be weighed against all the known disadv. of removing
bf from the life of this poor baby. Best wishes for a successful resolution.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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