Libby writes:
> the office and the baby gained well at the breast-I think 4-5 oz.

  Baby spits up "a lot" according to mom, stools only every 4-7 days.

He told me today he wants to do an analysis of her milk and check the stool
for fat, pH and reduction  substances to see if there is a malabsorbtion
problem.

we were making gains for a while.

Libby I can't answer your specific questions but I want to offer my gut
impression.
-problem solving rule number one "If it doesn't make sense - then it
doesn't make sense"
- Problem solving rule number two "don't assume"

This does not sound like malabsorption and I would not test the milk. {she
was gaining}
It sounds like this baby may be a "different" feeder [slower] than her
other children.
It sounds like this mom is very busy [and understandably stressed].
It is often difficult for moms to nurse as frequently or as long as we'd
like them to.
Spit looks much bigger when it comes out. [The upper GI was negative]
I would go back to what was working when the baby was gaining.
Make sure the hoofbeats don't belong to a horse before you go searching for
a zebra.

Gail
Gail S. Hertz, MD, IBCLC
Resident,  Dept. of Pediatrics
PSGHS Children's Hospital
Hershey  PA
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